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HomeMy WebLinkAboutPV2021-099 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application U � City of Newport Beach -Building Division � 7,oZI - OqN F- Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F -Building F- Grading rDrainage r', Elec r, Mech F-,, Plum Cu Yd Cut F Cu Yd Fill Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No It 611 _b(chUriQf - NOV ©rE06arrl1,cA F_ Description of Work Use F Const Type v �1R _,\j!g0,m �Qo(lo9/)V� ,1 4 Nan YM d # Stories # Units (if Resf Valuation $ New/Add SFF__ Remodel SF Garage/New/Add F Material/Labor U I d� ✓' OWNER'S NAME Last Fwaada __ First qso Owner's Address Owner's E-mail Address vVA�U-t(I�Ae,11mgIJ'Q GUS City State F Zip Telephone _ l0"I l0 %Z�' APPLICANT'S NAME Last First�(Q���y�� Applicant's Address u 1 Applicant's E-mail Address tmr� iQ ' m_? ��i1�rQar�h SQdIa►' city State F Zip ' Telephone (Iiq 960 -00V 5 ARCHITECT/DESIGNER'S NAME Last M (� r f (� First 15y (� W Lic. No. ( fig TM Architect/Designer's Address Architect/Designer's E-mail Address to clwil GUS City _ State F_— Zip Telephone (' 1i) 1 "t 1 U q n r ENGIN fR' A ELast ll V t'�' First (\1�ac Lic. No:�i Engineer's Address Engineer's E-maililddress City State—, Zip �— Telephone— \ITRACTOR'SNAME/COMPANY OeffuO "h �( olyi1 G Lic. No. �2 °14 V ClassF_10 -'s Address K/� Contractor's E-mail Address w_il5hiY12,�uQ. S1� �'d�' �Uq s�nt��a����vrmits@h�tP,i'o�►rff���//.sal<�►'' PI� State Gf Zip I Z Telephone /} 14 2(1 "1 SETBACKS FRONT ' t I PERMIT NO. SETBACKS RIGHT PLAN CHECK NO. DEVELOPMENT NO PLAN CHECK FEES $