HomeMy WebLinkAboutX2021-0749 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Saw
Comm'I ResidentialCity of Newport Beach - Building Division X,4o2/• O W/qjNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building F_ Grading r "Drainage rElec rMech F- Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire F- Liq F_ Landslide F_N/A Floor Suite No
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Description of Work
Use 'Const Type
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# Stories[— # Units (if Res)
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Valuation
Material/Labor
New/Add SF F_ 2-
Remodel SF `ID ' Garage/New/Add F_,
OWNER'S NAME Last
3EN IcINS First IT, CK) '..
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
iA 2l 5, First C:l iAn1 E
Applicant's Address
Applicant's E-mail Address
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State Lh Zip �;Z6 1�- / - Telephone �`((. '7-'-(2 �r cf E6
ARCHITECT/DESIGNER'S NAME
Last 13 -0mj FirstwwjJ Lic. No.
Architect/Designer's Address
ArchitecVDesigner's E-mail Address
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ENGINEER'S NAME Last
F) Koo /J First FlZE tJ Lic. No. C 13N IO
Engineer's Address
Engineer's E-mail Address
City _
State F_, ZipF Telephoner--.-�',
CONTRACTOR'S NAME/COMPANY
g C4N;iR C7ro� WC Lic. No. 836vq Class
Contractor's Address
Contractor's E-mail Address
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City .M/SSrorJ uIE,Tb -
State Cf+ Zip 717Oli Telephone �Llel 'H2 i11,,6
SETBACKS REAR
SETBACKS FRONT PERMIT NO. (iy •
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. &0~407
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $