HomeMy WebLinkAboutX2021-1536 - Permit Applicationxi
Works4eet for Building Combo Permit Application
City of Newport Beach -. Bu7ding Division
' CorKrm'1 [j Residential O TE:PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
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Building [Grading r]Drainege Elec ( tech lum Cu vd CutL I Cu rd Flu
Project Address (Not mailing address) —J Floor Suite No
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Description of Work
Valuation I
New/Add-SF `- Remodel SF _ Garage/New/Add �— MeteriaUlabo
OWNER'S NAME Last i First
# Stnriesi # Units (if Re
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Owners Address - Owner's E-mail Address
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APPLECANT•S NAME ' . Last
Applicants Address .
City Q �(�/ State CCk, I
ARCHITECT/DES►GKIER'S NAME: Last
Archita� ct/Des ner's Address
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City �a� i���� State [ lil`K E
First ( - - jttvy_
Applicants E-mail Address
Zip L ' ---�- Telephone
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Architect/Designer's E-mail Addrew
zip. P� TelephoneA.7+4
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ENGINEER'S NAME last First - _ Llc, No. `_
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Englneer's Address
City State
Engineer's E-mail Address
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Zip Telephone
CONTRACTOR'S!! AME/CQMRANY EliE% Llc. No. glass
Contractor's Address
city State C�
Contractors E-mail Address
Zip Telephone .
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ENERGY P/C FEE $ FIRE P/C FEE $ PE:RMtT NO,
GRADING P/C FEE $ PLANNING PEE PLAN CHECK NO�
PLAN CHECK FEE $
ELEC/PLUM/MECH P/C FEE $