HomeMy WebLinkAboutX2021-0034 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application �r�r `
r City of Newport Beach - Building Division X00? 003 6
r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL O ` G a "
b,Building rGrading rDrainage rElec rMech r, Plum cu yd cut Cu Yd Fin
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide [-N/A Floor Suite No
Description of Work
New/Add SFF— Remodel SF FI Garage/New/Add
OWNER'S NAME
Owner's Address
Lastl Qv" ^T' owe
Use Q-1 ! Const TypeF,
# StoriesF-2 # Units (if Res)s'
First I 'y _- 1-/01-0
��`` Owner's E-mail Address
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City h��Po state ZipF 014S4 Telephone jqq Cf3e 4 29 Z
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APPLICANT'S NAME Last p RP"PA ,-
Applicant's Address
116 - S' -c, va ua _ AVl&- S01rM 122-
City
122City v State �C,
ARCHITECT/DESIGNER'S NAME Last
Architect/Designees Address
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City oe-�t1W State C
ENGINEER'S NAME Last
Engineer's Address
city
City State
First'
Applicant's E-mail Address
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ZipFo/OZ-41
, Telephone I(9 .. 101, 44,46
First 0"( NIJ Lic. No. G7- 5')
Architect/Designer's E-mail Address
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Zip qd2�, - Telephone 3jn _9 4.26'
First F Lic. No.
Engineer's E-mail Address
Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address
City State F
SETBACKS REAR
SETBACKS
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
Zip [ Telephoned
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PERMIT NO. XW7A - DO3-I
PLAN CHECK NO. D02 -L - ZOZA
USE ZONE , L S L MW�4 F DEVELOPMENT NO PLAN CHECK FEES $