HomeMy WebLinkAboutX2021-1016 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application now
Comm'I r` Residential City of Newport Beach - Building Division �V� ' NOTE: PLAN CHECK FEES DUE AT TIME nFRI IMAITTAI
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Plum Cu Yd Cutl Cu Yd Fill
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r Fire r Liq i° Landslide rN/Aj Floor Suite No
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Description of Work
Use r— Const Type F_
# Storiess # Units (if Res)s
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OWNER'S NAME Last 7a r6b sCP/ '
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.First �
Owner's Address
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Owner's E-mail Address
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Zi P 960pt S Telephone 3/®
APPLICANT'S NAME Last
First d7PCi��s
Applicant's Address
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Applicant's E-mail Address / ,/�
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ARCHITEC ESIGNER'S NAME Last First d l Lic. No. r�
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Architect/Desi eds_Address"—'
Architect/Designer's E-mail Address
City State r--- Zip r-- - - -,Telephone
ENGINEER'S NAME Last�
First Lic.No.F—
Engineer's Address
Engineer's Vmall Address, Ai
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city /7"10 C-.. /I. : State F Zip
9�3r� TeVephone �
CONTRACTOR'S NAME/COMPANY / A // 1�
Lic No. �56�{j Class
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Contractor's Address
Contractor's E-mail Address
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City A✓( �. Gi StateC ZAP
91 TelephoneFlY
SETBACKS REAR SETBACKS FRONT
PERMIT NO. B
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SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK 1\10.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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