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HomeMy WebLinkAboutX2021-1868 - Permit Applicationtiu,tt- ?.c�Z1I xwz1-I &'cow Print Form Worksheet for Combo Building & Solar Permit Application F Comm'I KResidential City of Newport Beach - Building Division a m ? NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL wilding F -Grading rainage rElec rMech F- Plum Cu Yd cutF Cu Yd Fill Project Address (Not mailing address) F Flood r Fire r Liq (— Landslide F—N/A Floor Suite No 15.07 &,m rJ S'r4C--w UfA I Description of Work Use I— Const Type F— # Stories # Units (if Ress Valuation $ MaterialZabor New/Add SFF Remodel SF F Garage/New/Add F— OWNER'S NAME Last �A 1 bCl� First Owner's Addrre/ss Owner's E-mail Address City ��� 1J f State F — Zip 7Z(o © Telephone g -23`2 03-7.yam APPLICANT'S NAME Last L S p ti First I ' f V' C Applicant's Address Applicant's E-mail Address 2,-- ) /-- /-AZA City U1Z!E7S J State I (J*— ZipC72;Telephone C76a O0� ARCHITECT/DESIGNER'S NAME Last FirstF Lic. No. Architect/Designers Address Architect/Designers E-mail Address City State F— Zip [ TelephoneF— ENGINEER'S NAME Last �— First I Lic. No.r Engineers Address Engineer's E-mail Address City I State F— Zip F— TelephoneF— CONTRACTOR'S NAME/COMPANY /JrA� jet { Tic Lic. No. 9— Class , l Contractors Address E-mail Address City q ��d�%d U� a State I 5T-- Zip 50 Telephone Fr%RF .` l SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $