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HomeMy WebLinkAboutX2021-2359 - Permit ApplicationSEW Poq ition a Print Form Worksheet for Combo Building &Solar Permit Applic City of Newport Beach - Building Division r Comm'I �( Residential NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Elec ( Me Plum -------- Cu Cu Yd Fill g Draina e N/A Floor Suite No r Building [— Grading I— 9 Fire Liq Landslide F Project Address (Not mailing address) I� Flood Use ConstType F Description of Work 0 # Storie5F # Units (if Res)r' Valuation 5 Fi� Rom' Material/Labor New/Add SFr------ Remodel SF�--- ✓ '� Garage/New/Add OWNER'S NAME Owner's Address City �— APPLICANT'S NAME Last \%�vA �, V ` ^ First CAYRct/ Owner's E-mail Address State Zip Telephone----- Last I 7�4 l w Applicant's Address �S 1 +✓�' u��'�`- State a City jJEu/ Q ARCHITECTIDESIGNER'S NAME Last ArchitecVDesigner_ s_ Address State r� City --- Firstr i Applicant's E-mail Address \ 1 -1-«C\,i.0 (rvt r �P. YlC- (\ L�. 1. C'L•�`/� Zip Telephone ll FirstLic. No.r------_— Architect/Designei's E-mail Address Zip r� Telephoners' First Lic No.r� ENGINEER'S NAME Last Engineer's E-mail Address Engineer's Address. r �- State F� Zip �— , TelephoneF City I Classy----- Lic No. CONTRACTOR'S NAMEICOMPANY Q41v,101- Contractor's E-mail Address Contractor's Address_ Zip �— Telephone�— State r-- n A - City nAAi'I ✓1C3 _ L SETBACKS REAR SETBACKS LEFT ')NE SETBACKS FRONT SETBACKS RIGHT DEVELOPMENT NO PERMIT N0. PLAN CHECK NO. PLAN CHECK FEES $