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HomeMy WebLinkAboutX2021-3289 - Permit Applicationa2024-5q%0j Print For Worksheet for Combo Building & Solar Permit Application F_ Comm'I r<Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F_Building [ Grading r -Drainage rElec r-Mech r Plum CuvdCut F Cu Yd Fill F Project Address (Not mailing address) F_ Flood f` Fire F_ Liq F- Landslide CN/A Floor Suite No Description of Work Use(N - Const Type F— # Stories # Units (if Res)T C to ." (�MUd ( / /c-1 ", OAI\ Valuation SF�—Remodel SF C�Garage/New/AddF $ F ODONew/Add Material/Labor OWNER'S NAME Last -/i l/\ First _ /� �G t J C 9 C { J^p 6"', Owner's Address Owner's E-mail Address City �ec_(L State�- Zip—.. Telephone APPLICANT'S NAME Last. _ First (� Applicant's Address Applicant's E-mail Address CZC2 fr City C< StateI_ Zip `� Telephone f ARCHITECT/DESIGNER'S NAME Last *, C_ First e- — Lic. No. C- }115 Architect/('Designer's Address itect/Desitgnneo�r's E-mail Address �j City% _...I f(� State Zi Q`J f-5�., Telephone[rc� ©V�� L l' `First ENGINEER'S NAME Last 11_ (/U t� �— Lic. No.F_.----- Engineers Address Engineer's E-mail Address City _ State F-.--, Zip F Telephone -- CONTRACTOR'S NAME/COMPANY © / (� Lic No. r — - - —' Classy Contractor's Address Contractor's E-mail Address City State �— Zip TelephoneF� SETBACKS REAR SETBACKS FRONT PERMIT NO.Z SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $