HomeMy WebLinkAboutX2021-0847 - Permit ApplicationPrint Form
Comm'I 'F Residen
W t for Combo Building
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NOTE:
& Solar Permlt pplication
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building rGrading Drainage V<Elec 5;Mech
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Project Address (Not F_. Flood
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#Stories #Units (if Res) '
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Valuation $
Material/LaborAI
New/Add SF� ', Remodel SF Garage/New/Add —
OWNER'S NAME Last 1<-4W1V (% jqr
First K0
Owner's Address
Owner's E-mail Address
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City State
ZIP �2,b.6Q, Telephone
APPLICANT'S NAME
First
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Applicant's Address
Applicant's E-mail Address
City State F Zip �— Telephoned----
ARCHITECT/DESIGNER'S NAME Last fj �
FirstFN"visL Lic No. C% -2-67177
Architect/Designer's Address
Architect/Designer's E-mail Address
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City / l/�N State Fo,, Zip Telephone s#+, W44-p�
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ENGINEER'S NAME N/l'9 Last
First F_ Lic. No.F-------'
Engineer's Address
Engineer's E-mail Address
city State F_. Zip F— Telephonew
CONTRACTOR'S NAME/COMPANY jVlplU r% VIM/y - 0, - I , �c��idJ7 Lic. No. 'gqrd 41$3 Class
Contractor's Address
Contractor's E-mail Address
Cityilil7�t-�_ &,40- State a-t� Zip '7' ?_77 Telephone'
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N``O��. -
USE ZONE DEVELOPMENT NO
PLAN CHECK FESS"$`
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