HomeMy WebLinkAboutPV2021-234 - Permit ApplicationPrint Form;" Works ee
Vor mbo WuI Ading & Solar Permit Application
F- Comm'I r; Residential City of Newport Beach Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL<„p=^
Building F_Grading Drainage J7Elec r—Mech f— Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing
address) F7 Flood F. Fire r Liq r Landslide F_N/A Floor Suite No
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Description of Work
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OWNER'S NAME Last F vc�c�t First
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last First I ti rr,
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last first .� t t Lic. No. 3
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Architect/DesigneesAddress -
Architect/Designer'sE-mail Address
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ENGINEER'S NAME Last
First Lit: No.F
Engineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
3Y75 V_VJ or
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SETBACKS REAR [ py
11
SETBACKS FRONT PERMIT NO. Ur LiUL q ' -5
SETBACKS LEFT ��
SETBACKS RIGHT PLAN CHECK NO