HomeMy WebLinkAboutX2021-0956 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
XComm'l r— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DIJF AT TIME nF cr IRUITTCI../ c..
Auilding f— Grading F—Drainage r" Elec r Mech r Plum CuvdCut cu,vdlill
Project Address (Not mauling address) F Flood (— Fire [ Liq [° ,Landslide (-N/A Fioor, • Suite No
Description of Work
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Use Const Type F
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# Stories # Units (if Res)s
New/Add SFr--.-�-- Remodel SF� Garage/New/Add --
Valuation$
Material/Labor �� i i � d u3
OWNER'S NAME Last�
C', First CTA_
Owner's Address
Owner's E-mail Address
(221- (L -1'Y
City
State E Zip\Z�y�? Telephone 4)2`62 3f ( 4
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
city F11�.v �/�'� _.
StateG(._ Zip Telephone �>
ARCHITECT/DESIGNER'S NAME
Last First r --
Architect/Designer's.Address
Architect/Designer's E-mail Address
L^ `
City � (C,v l h+c
State(_;� Zip. 2�c Tele hone Ff /&' Q 1rl®7
ENGINEER'S NAME Last
First [IS -- lic. No. C
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Engineer's Address
Engineer's E-mail Address
CItY
State (j�,_ ZipC-7KC,\L',ti Telephone 9
NAME/COMPANY
r` lLic.NoCONTRACTQR'S tto
d6L S e nf J 3 1 /59Cass r,.i
Contractor's Address
Contractor's E-mail Address
city '
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State / Zi iy � < = ..
[�'f �P .1 �,�4(,/ Telephone.�7 �C..�`i-i7rdl
SETBACKS REAR
SETBACKS FRONT. PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHTLAN CHECK NOV CAU, `y (,+,,
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USE ZONE
DEVELOPMENT NO - r ate'
y LAN CHECK FEES $ ; "')' r ,3 y