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HomeMy WebLinkAboutPV2021-243 - Permit ApplicationPrint, For Worksheet for Combo Building & Solar Permit Applicatli'on ��E °°*m F- Comm'I F_ Residential City of Newport Beach - Building Division ? v %/O ii+ •t/� 13 o a NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5<��0=�" P�'Building r Grading rDrainage r Elec r Mech r Plum cuvdCut F Cu Yd Fill F Project Address (Not mailing address) ,F- Flood F- Fire r Liq j- Landslide F_N/A Floor Suite No Description of Work Use F_ Const Type F_ � ® , C � e � / Ar # StoriesF # Units (if Res)- _.._.. _ ...._ _.... _. Valuation Material/Labor bor f New/Add SF (.a 0 Remodel SF�Garage/New/Add F— OWNER'S NAME Last �- ! (; _ C'� First Owner's Address Owner's E-mail Address r City d�'t;:^�j1\�.pi ly1�i"t, C,. �State 7,771 _ Zip `1��,-1t' I -:C) Telephoned APPLICANT'S NAME Last e �� ej� First J Applicant's Address Applicant's E-mail 4ddress ' `7 CA -7 A/ M ft,) l� S Snm� Uri -,1:n �eo0 o_R _Z, . City O T G11CJ-2 State [—. Zip y Zg�jj Telephone(: -?Y'?- 29�' 9th ARCHITECT/DESIGNER'S NAME Last First Lic. No. F_ Architect/Designer's Address Architect/Designer's E-mail Address City State F_ Zip F— Telephone ENGINEER'S NAME Last .First F_ Lic. No. Engineer's Address Engineer's E-mail Address City State Zip— Telephoned CONTRACTOR'S NAME/COMPANY e�S Lic. No. d SY/ 3 Class C- / Q i Contractor's Address Contractor's E-mail Address �] ) ZE- l�tl'i {')'!e LJ ISel City _. State _M ZiPZ�G Z qTelephone 9q,?_ y�O�w�`y © 1 ra' I , V SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 61