Loading...
HomeMy WebLinkAboutX2021-1522 - Permit ApplicationPrUrt Form Worksheet for Combo Building & Solar Permit Application vW04-T.,Comm'I ( Residential City of Newport Beach - Building DivisionoNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F Building F_ Grading FDrainage 1I Elec r, Mech Plum Cu Yd cut Cu Yd Fill Project Address (Not mailing address) F Flood I` Fire f- Liq F_ Landslide [N/A Floor Suite No Description of Work , C UM na- 14 Use ConstType tI I C?� 73 II�r`�c mn Zx=�0/� #Stories #Units (if Res) Valuation $ Material/Labor v0 0 New/Add SF�'-- — Remodel SFF---..-- Garage/New/AddF --' OWNER'S NAME Last �t N� I First FA4A S Owner's Address Owner's E-mail Address . City " - A" ,q-.G� State zip9 2�!/�OU Telephone gy�� SU 2 — ��.2- (o APPLICANTS NAME Last Le ,� f First Applicant's Address Applicant's E-mail Address 3i1 W LAle-e CC'��e✓ QiA_ _ JAUt� ewis �t(Arrdl�r�irJ� coV-% City ., .-._�r,�{k, _ State C _. ZiP_RZ%Qy Telephone -q t{C7$'G °-fUG.._. _... �07 ARCHITECT/DESIGNER'S NAME Last Firs Lic. No. C j�102 2 Architect/Desi ner's Address 9 ArchitecUDestigne s Email Address City qA* 6A,4, ,+A ', State Zip Telephone Gi 61 29,57 O6 oo ENGINEER'S NAME Last � G(J First % vZl) Lic. No. G 5' -Z Engineer's Address Engineer's E-mail Address city S /' a _ C �K • _ State C A. ZiP 113 ©d Telephone Gj � � -�S J -Oi i7 U U CONTRACTOR'S NAME/COMPANY J � / a ZUr p Lic. No. (Q�Gaoz- ass Cy; V" TC,C� Contractor's Address Contractor's E-mail Address 3y1 w LalC? _ %_�i �Xhvrcy i1 GG �! �f t�t�lk"�IND(fI city �SP A- [40A- _ _ State F—CA-- — Zip Gf 7_70 Y Telephone 7f 1 1 03 CJ c/ lye SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $