HomeMy WebLinkAboutX2021-2357 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Comm'Ii Residential City of Newport Beach - Building Division ��
NOTE: PLAN CHECK FEES ntir AT TiMF nF Ri iizreiTTni Vf=
F-Building F_ Grading F-Drainage F-Elec F_Mech F-PlumCu Yd Cut F_Cu Yd Fill
Project Address (Not mailing
address) F- Flood j- Fire j- Liq F_ Landslide FN/A Floor Suite No
3906F
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Description of Work
Use 5,F ConstType�
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# StoriesF_ If Units (if Res)[_
�10
Valuations n „�
Material/Labor t/�)
New/Add SF� Remodel
SF Garage/New/Add
OWNER'S NAME Last
I,055✓1 First f,l -k
_' "I
Owner's Address
Owner's E-mail Address
310\6 (,; v e/_ rA �e �� rro
City IyekJ�O� i3L(� StateFCC;Zip �� Telephone�-
APPLICANT'S NAME Last
oc,/-�U.S First Tt1G
Applicant's Address
Applicant's E-mail Address
2-03I {�+�tN'e SJ
S•
�
City S�/' .. C,
State F_ Zip ay1 U Telephone[]]Lj %%Q/
/First
ARCHITECT/DESIGNER'S NAME
F__
Last
Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip f Telephone F_
ENGINEER'S NAME Last
First F_ Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip [_ Telephoned
CONTRACTOR'S NAME/COMPANY
� G �,r Q Lic. No. S:j9 � 1 � Class e ��
� t
6
Contractor's Address
Contractor's E-mail Address C. 12,
Zv31 S, erne
City srv�-' �t^r^
14 owcrf�-}i51,'h �arie-1'G�t�u•c�-,
State FCE-
Zip iq,a gy Telephone )ly
SETBACKS REAR
SETBACKS FRONT PERMIT NO. X�Ge�LI -S
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
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DEVELOPMENT NO �� _ Ci��-.7(J PLAN CHECK FEES $