HomeMy WebLinkAboutX2021-2791 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Ap cation2 JVoy�E gra
( Comm'1Residential City of Newport Beach - Building Division
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Project Address (Not mailing address) F Flood r- Fire F- Liq r- Landslide rN/A Floor Suite No
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Description of Work (jj' ,L{r
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Valuation $
New/Add SFr— -- -, Remodel
SIFF F � - Garage/New/Addy
Material/Labor
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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City _Kset taVT _&Yt44
_ State C� Ziprt( j ...Telephone Q4�-lo: 7--6878
APPLICANT'S NAME Last
FRA t&i First I -OA Ul o
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last A(Cc�l First F(jP60 Lic. No. V L7 40
Architect/Designer's Address
Architect/Designer's E-mail Address
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State I Z4 —, Zip Q&, j�_ Telephone9"49 — Y?,_4400
ENGINEER'S NAME Last
First K �^ Lic. No. FC837S3
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Engineer's Address
Engineer's E-mail Address
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City L,160-�+ 14t,,( -J
State CFS- Zip iWr-,J Telephone
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CONTRACTOR'S NAME/COMPANY
((� Lic No. F --, ClassF
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Contractor's Address
- Contractor's E-mail Address
City
State r Zip r -®-- Telephone[
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. > Q
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $