HomeMy WebLinkAboutX2021-0751 - Permit ApplicationPrint FormWorksheet for Combo Building & Solar Permit_ Application 6a,
F Comm'I Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading F -Drainage Elec ` ech lum CuvdCut CuvdFill
A
Project Address (Not marlin/ggaaddress) .._ Flood F_' Fire -KLiq r Landslide F_N/A Floor Suite No
Description of Work
Use Const Type
# StoriesF # Units (if Res)
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Valuation $
Material/Labor
New/AddSF� Remodel SF1� Garage/New/Add
OWNER'S NAME Last
Last First ,
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Owner's Address,U f f� v Owner's E-mail Address
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state zipTelephone 6202-,131,15- Gt
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APPLICANT'S NAME Last ,'o/,j�a First
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Applicant's Address P/ t°d yot� E n r,fi Tz ^Ib c � App'lcant's E-mail Address
City- i Y'r�J - State17z Zip ^Telephone �Q
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ARCHITECT/DESIGNER'S NAME Last First T
- Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
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City 6°/�f $°�rn,a� "i State Zi Telephone
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ENGINEER'S NAME Last (� I�r y f a� First Lic. No. -
Engineer's Address Engineer's E-mail Address
City �— State F-, Telephoned
CONTRACTOR'SNAME/COMPANY Lic. No, Class
Contractor's Address Contractor's E-mail Address
City State F Zip Telephoner
SETBACKS REAR SETBACKS FRONT PERMIT NO. •
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.