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HomeMy WebLinkAboutPV2021-135 - Permit ApplicationWorksheet for Combo Building & Solar Permit ApplicationqgIp"jiCity of Newport Beach- Building Division %?,y3 WV`l� V AV romm CI Residential NOTE: PLAN CHECK FEES DUEAT TIME OF SUBMITTAL wilding rX'', Grading iXDrainage rl Elec rX'Mech FX Plum CuYdcut Cu Yd Fill Project Address (Not mailing address) IX Flood r, Fire (X Liq FX- Landslide rN/A Floor Suite No Description Irk W1 Use F Const Type %,(p�U1 2� 5 'LL�iWWcrat S/tHs # Stories # Units (if Res)_ _... _... New/Add SFF Remodel SF Garage/New/Add valuation $ ,Z4 ©D� Material/Labor 9 OWNER'SNAME Last F96CFirst f�iY1q Owner's Address Owner's E-mail Address 2353,.,. /she 4 _ City ive v.CLState I C/ zip F C(eo Telephone 'I Lei 63_i APPLICANT'S NAME LastIiA ,tom First ani Applicant's Address Applicant's E-mail Address 9 33 A),,w S` CityState Cos 1 `� Zip x% 27 Telephone `f�f 31 (V , Y •�Z6F` (m2 ARCHITECT/DESIGNER'S NAME Last F First Lic. No. Architect/Designer's Address Architect/Designees E-mail Address City State F Zip _ Telephone ENGINEER'S NAME Last ���J First � Lic. No. Engineer's Address Engineer's E-mail Address c/�.e t� 2c� jL����!�� r—� � P52-6 Ci State Zip t6jo Telephone �4f� �� S/ CONTRACTOR'S NAMEICOMPANY r� Lic No. Q2g24,_ ClassGYGt13 C Contractor's Address Contractors E-mail Address City I E j`Y c4A State 9 � Zip [`724,2-7 Telephone � pg 4v5 3-, 3j FRONT PERMIT NO. IV / Zj SETBACKS REAR SETBACKS SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $