HomeMy WebLinkAboutX2021-1231 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 00 `«'°"e
F- Comm I r Residential City of Newport Beach - Building Division � 7A Z I - ILj1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Gu.oa�,.
(Building r— Grading
[—Drainage rElec rMech (-Plum Cu Yd Cut Cu Yd F111
Project Address (Not mailing address) r Flood r Tire r Liq r Landslide rN/A Floor Suite No
Description of W
Use F—Const Type
MA P�7
# Stories #Units (if Res)
New/Add SFI- — ---
Remodel SF - —' G e
Valuation
Material/La bor Ft�
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City r _._.
_. State F— Zip r___ Telephone--
I
APPLICANT'S NAME
First
L4 lei
Applicant's Address
JUJAApplicant's E-mail A Ss
City
State I— Zip Telephoner—..
lk
ARCHITECT/DESIGNER'S NA
a t Lic No.
Architect/Designer's Address
D si a E-m//aa l,,A``ddd/d��ress
City r
State Zip l------- Telephoner-------..
zxb
ENGINEER'S NAME
11113
Last First r---- :i41y.
Engineer's Address
Engineer's E-mail Address IL
City
_. State f Zip r-- Tel
c
CONTRACTOR'S NAME/COMPANY Llc. Class,
Contractor's Address
Contractor's E -m ihAd s
City
State Zipr— Tele ne
SETBACKS REAR 10
SETBACKS FRONT PERMIT NO. �
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $