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HomeMy WebLinkAboutX2021-0641 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application qm��City of Newport Beach - Building Division ov o r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT wilding F_ Grading F -Drainage F- Elec F Mech r Plum Cu Yd Cut F_ Cu Yd Fill l Project Address (Not mailing address) F__ Flood F_ Fire F_ Liq F_ Landslide FN/A Floor Suite No dog � r Description Wo/r�k Use �e-Const Type (o'�f \ #Stories #Units (if Res) K nto Valuation $ Material/Labor New/Add SF I Remodel SF Garage/New/Add F OWNER'S NAME Last \ I 1 (0. /�i ... First �- ' ` Owner's Address Owner's E-mail Address Ll D B em� y- L��,e City ` ) 2 O r- State Fa`, Zip f -.-.- Telephone` APPLICANT'S NAME Last First t� ' �L-� , , - Applicant's Address Applicant's E-mail Address IPO �A City 0ay� J State Zip Telephone -7130 ARCHITECT/DESIGNER'S NAME Last iburp, First --Lic. No. Architect/Designer's Address ArchitecUDesigner's E-mail Address City-----..--.-__.....__— _ State I.. Zip F—',, Telephonel---...--.-.--....__ ` ENGINEER'S NAME Last 'A�t ✓��J First (- © Lic No. C- q 1 Engineer's Address Engineer's E-mail Address �. J� J"1�� t tet% Pc,r � C_b�� � �• C��� I- City �A i O i .. State Zip %..r 7 Telephone Y4 Z7 (-,� 3.1 (/ I `� CONTRACTOR'S NAME/COMPANY C . S Lic No. 1 t (p`�b�l Class �or- Contractor's Address Contractor's E-mail Address �12?2 Sero ��v ItV C1ee_e-rTr1�54eC) tr-Low. City \Yv State I E Zip Cl ce t � Telephone F'1 0 ^ Z(,7'Z- %41Q SETBACKS REAR SETBACKS FRONT PERMIT NO. 'X (^ o 6 f SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. CJ5C43 - _0_ USE ZONE DEVELOPMENT NO PLAN CHECK FEES $