HomeMy WebLinkAboutX2021-2542 - Permit ApplicationPrint Form
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Worksheet for Combo Building & Solar Permit ApplicationJJ
Residential City of Newport Beach - Building Division x 2A2/j 2� I
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F4uilding F_GradingrDrainage
Elec rMech F-PlumCuvdCut F CuydFill s
Project Address (Not mailing address) r Flood F- Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use ConstType
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2 �� 1
L
w�yr
# Stories # Units (if Res)r—
_ f'
'y a rz /l �Q
E�'(L5� I
Valuation I V
Material/LaborF_ / O
New/Add SF�
Remodel SFs Garage/New/Add
OWNER'S NAME
Last .—�- V i N, ' First
Owner's Address
Owner's E-mail Address
City
State � Zip � Telephoned
APPLICANT'S NAME
Last p� First �' m m�j 1
Applicant's Address
Applicant's E-mail Address
vdo f e i/)V ANFs S • c-o m
City � 4
State G�i Zip Gj17o2 Telephone 6((i _U -6 Ise)
ARCHITECT/DESIGNER'S NAME Last 0 1 e First
✓\ 1� Lic. No.
Architect/Designer's Address
ct/Designer's E-mail Address
City
State F_ Zip F__ Telephoned
ENGINEER'S NAME
Last First Lic. No._
Engineer's Address
Engineer's E-mail Address
City
State F___ Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY'16r S Lic. No. ID�OYi2 Class G.tlrs
y'
Contractor's Address
V{
Contractor's E-mail Address
gru'nf S - -rrwivvWe, 1�-ry e, 4-N�Sr S •co,�-�
City jE7—
G�
State �Zip Jqo? Telephone �Z, gy/ . g4jcjc7
SETBACKS REAR
SETBACKS FRONT PERMIT NO. ZA �jrt Z—
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 7jso;_ L45 1