Loading...
HomeMy WebLinkAboutX2021-0996 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application ��<wP�q,. Residential City of Newport Beach - Building Division t " NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U� / r Grading (—Drainage F_ Elec r Mech r Plum I� Cu Yd Cut l Cu Yd Fill A Address (Not mailing address) F Flood F Fire r Liq j! Landslide rN/A Floor Suite No � ,ription of Work �� Use onstType� /t 6F �� 3(-�jpt # Stories #Units (ifRes)I `� `) Sw/Add SFF— Remodel SF�— Garage/New/Add Valuation 5 Material/Labory. OWNER'S NAME Last ©1JZC�l�NI A First / Owner's Address Qf�a/fp'�i-iGL2Jsl Owner's E-mail Address ''� c�tCSCCY�3_ �dJrJffS�C�Y Cityhoned--- - APPLICANT'S NAME Last Applicant's Address � G2i�—z� �Lr)�-70 City '[��y0�`1.� State C�_ ARCHITECT/DESIGNER'S NAME First) N-+xz„C_-� Applicant's E-mail Address ZIP I C7� �) Telephone (OS Last . 7" First �O Architect/Designer's Address `�. Architect/Designer's E-mail Address Lic. No. C City �,1��1f1ES/V State �[jIQ - Zip �cZ-( Telephone �)�9(���Ol�� ENGINEER'S NAME Last to Engineer's Address City State CONTRACTOR'S NAME/COMPANY t cam Contractor's Address City C L—ir qi;�e State �— SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USEZONE DEVELOPMENT NO First I Lic Nof-- Engineer's E-mail Address t ZIP [� Telephone t`bs� )Q f Lic No. SClass Contractor's E-mail Address �3Yct�Ntc�y��cch�Pa Zip Telephone PERMIT NO. PLAN CHECI PLAN CHECK FEES $