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HomeMy WebLinkAboutX2021-2715 - Permit ApplicationY,'?Z 7�i ? _e i Print Form Worksheet for Combo Building & Solar Permit Application F- Comm'I F- Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL <uiId1ng F_ Grading rDrainage rElec F_Mech r-plumCuvdCut F_ cuvdFill Project Address mailing address) r- Flood F_ Fire r- Liq r' Landslide CN/A Floor Suite No ]](Not LJ / f� 1 ✓v d/ G c F Description of Work Use [_ConstType �: l tt (( 1I`-. )19 L12i`Mn , ( 1_C1 C�c�li. c'LZ\ f-�j-{c .^ Vvn11 `y U{ # StoriesF_ # Units (if Res) Valuation$ (. Material/Labor New/Add SFF-._--- RemodelSFr Garage/New/Add- OWNER'S NAME Last j 4 _6(VqLj First ...._ 61 Owner's Address wner's E-mail Address I, LJ ?'1�%��,_{J✓.. "��' 1 -... �'� f ._... t/`(fv'�/, 4Y1L(C. yJ'N�G�ib City State I i'c ZiP � 61,7 Telephone '(_qq 0 7_ , 00 APPLICANT'S NAME Last �' }� _ First Applicant's(( Address Applicant's E-mail Address (. / C,.i�� U/Jti/�t l/iCC City %`JS �in 'c�:-'s_..., State C Zip. Five �,T Telephone 1�...190:..�. ".1*U l ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State �— Zip r- Telephoner_ ENGINEER'S NAME Last r Firsts- Lic. No.f Engineer's Address Engineer's E-mail Address City r--- State F Zip r--- Telephoner— CONTRACTORS NAME/COMPANY }}. 7 r �l% ({iZU f Lic. No. Iii 1 Class Gi0 Contractor's Address Contractor's E-mail Address cx-,) a City r4 a�< '1 c State C. + Zip Fie !q Telephone 9 0 0 _ ( Z J SETBACKS REAR SETBACKS FRONT / PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �._ • r USE ZONE �^ DEVELOPMENT NO PLAN CHECK FEES $