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HomeMy WebLinkAboutX2021-2882 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permitpp Application Comm'I (Residential City of Newport Beach - Building Division T AL NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT AL oa" F,Building F_ Grading rj>{rainage ri4lec j—Mech cu yd cut Cu Yd Fill Project Address (Not mailing address) F, Flood r Fire F_ Liq Landslide F_N/A Floor Suite No -zein Description of Work 1 ��� 1. � `�1' Use Const Type l3AcC /4 Wi # Stories, # Units (if Res)F ...�u .. _ Valuation $ New/Add SF� Remodel SFF— Garage/New/Add FI Material/Labor OWNER'S NAME Last S 56,i- First M72 Owner's Address Owner's E-mail Address SLlr^E _ ._ City State Zip Telephone 37� �6C��C-� � I .. �ZL APPLICANT'S NAME Last S First �y12 Applicant's Address Applicant's E-mail Address City State F Zip F_ Telephone ARCHITECT/DESIGNER'S NAME Last A /, Firstj��� Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address ><l �5 City : -74 A A �Q _ State Zip �� 5 Telephone 5�Z— 33F� , !© ENGINEER'S NAME Last First Lic. NoF Engineer's Address Engineer's E-mail Address City State F— Zip F Telephone CONTRACTOR'S NAME/COMPANY Lic. No. F Class' J Contractor's Address Contractor's E-mail Address City State Zip F Telephone �i SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. D1j I icC Ennio ., a: