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HomeMy WebLinkAboutE2021-0084 - Permit Applicationnot FormEWA "Worksheet for Combo Building &Solar PerlTiit`App)Ft;atiorr F_ Comm'I f- Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o ." Buildi ' r: nlg.Gradin g r;Draina ga Elec r Meth F , Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) F_ Flood f , Fire F Liq F- Landslide FN/A Floor Suite No 300 F� _ \f J, _ Zv Description of Work Use F ConstType #Units (if Res) �•�« nuv .� S a cl kNs1w �ie.�, ^-'#'"Stories; Valuation New/AddSFF— Remodel SFF Garag a/New/Add—I Material/Laa bor OWNER'S NAMELast First_I'' Owner's Address Owner's E-mail Address City State Zip F_,, Telephoned APPLICANT'S NAME Last ACL&wCCA First I jV r Applicant's Address Applicant's E-mail Address' G fq-z � u n PL_ City r-cx cf�u CUcavn�n�q State Ccl Zip FC1173.Telephone LC•-Z7/-ji3`j AREMIT!Gi/DESIGNER'S NAME Last First Lic. No. i Architect/Designer's Address Archite ct/Designer'sE-mail Address t(�%� City State r.� ZiP Telephone J _ 1 ENGINEER'S NAME Last FirstLic.Lic. Nof—' Engineer's Address Engineer's E-mail Address City �— pn4L State r Zip Telephone CONTRACTOR'S NAME/COMPANY lc -,co PU C, b)eca - Inc Lic. No. Ne n Class c o Contractor's Address. Contractor's E-mail Address f p o �o "CEChv Cat 0 ecor 'a- G . L.6 City J 2G ) t7t Q�KG ,, .. �- State C Zip 9 r 73 � Telephone CZ 6; _ 2 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $