HomeMy WebLinkAboutX2021-0383 - Permit Application1; Print Form I ' Worksheet for -Cornbo BuildingA Solar Perv�o% pphc eaUC) rr],
Comm'I City of Newport Beach - Building Division
(` Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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r Building F Grading r—Drainage F_ Elec r Mech F- Plum Cu Yd Cut l Cu Yd Fill F
Project Address (Not mailing address) F_ Flood r— Fire F_ Liq r Landslide F_N/A Floor Suite No
Description of Work Use Const Type
F_
ICY � �.�r�- � ►�
# Stories # Units (if Res)I_
Valuation $�
New/Add SF Remodel SF�- Garage/New/Add f Material/Labor
OWNER'S NAME Last I First
Owner's Address Owner's E-mail Address
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I —
City State �® Zip Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State r Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Arch itect/Designer's E-mail Address
City � State F— Zip Telephone
ENGINEER'S NAME Last I First I Lic. No.I��
Engineer's Address Engineer's E-mail Address
City �— State Zip Telephone
CONTRACTOR'S NAME/COMPANY��� Lic. No.Class
Contractor's Address Contractor's E-mail Address A 4►
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City State zip
i Tele hone
SETBACKS REAR SETBACKS FRONT PERMIT NO. -
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO __� PLAN CHECK FEES $