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HomeMy WebLinkAboutX2021-3413 - Permit ApplicationPrint Form �// Worksheet for Combo Building & Solar Permit Application >WP6 r Comm'I (`i/Residential City of Newport Beach -Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL FvBuiIding r Gradingc oa s j-Drainage j-Elec j—Mech F'-Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) r- Flood F- Fire F Liq F_ Landslide 5<�/A Floor Suite No Description of Work — _ Use F— Const Type St i?t--c IL �X T-� 'Sirnr # StoriesF_ # Units (if Res)F_ Material/La New/Add SF� Remodel SF�— Garage/New/Add �— Valuation $ bor CJ C c OWNER'SNAME Last _��\ � -Zt ,�'- First.. JC`'C j1 f 1 Owner's Address Owner's E-mail Address y. Cityit -- - �'F �7iy24 Teleph ILC_� - '� ' c•r..,'- € - State �— zip�— Telephone APPLICANT'S NAME Last //\.,f /I First )� ' Applicant's Address - - 2- ' ( Applicant's E-mail Address 22 ri �'s.i va6tit •%c { T`_�is v 1 City '[�c L rl� j State Zip 2 Telephone jic, i/ �, e: 1 ` / s _ ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. F— ArchitecUDesigner's Address Architect/Designer's E-mail Address -- _ � �— �— City State Zip Telephone ENGINEER'S NAME Last First Lic. No.� Engineer's Address Engineer's E-mail Address City State — ZiP F— TelephoneF� CONTRACTOR'S NAME/COMPANY Lic.No. �— Class F_ Contractor's Address Contractor's E-mail Address City State r— Zip [_ Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. i/l (� I SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0. L ol, USE ZONE DEVELOPMENT NO PLAN CHECK FEES $