Loading...
HomeMy WebLinkAboutX2021-1216 - Permit Application2o2I -121 X 3 70G e, Xv P�irtt Form Worksheet for Combo Building & Solar Permit Application saw - F_ Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ,,' P'Building Grading [—Drainage rElec f—Mech FPlum Cu Yd Cut F_Cu Yd Fill Project Address (Not mailing address) F Flood F_ Fire F- Liq F_ Landslide CN/A Floor Suite No Description of Work Use �Q Const Type " ff Cqin jou I wo ( c' C4 # Stories # Units (if Res)[— Valuation Material/Laa bor) 00 New/Add SFr ---- Remodel SFI o Garage/New/Add f -�—, OWNER'S NAME Last W ©e First NZ Z–1 Owner's Address Owner's E-mail Address ct�Clr\/E� N��_i�•tr �c ®1c(owl.w city P 0 State F___--.. Zip I dt Telephone[ l �FirstF APPLICANT'S NAME Last C ( d( Applicant's Address Applicant's E-mail Address ion ` _ UJ I L City �S d.. I .� State r._�,V Zip [— Telephone) 'DR I ARCHITECT/DESIGNER'S NAME Last First F- ---- Lic. No. F__ Architect/Designer's Address Architect/Designeer's/E-mail lAAddress CityState �.--. Zip _ Telephone--�--- ENGINEER'S NAME Last First F---.-- Lic. No.l— Engineer's Address Engineer's E-mail Address City State �--- Zip TelephoneF_ CONTRACTOR'S NAME/COMPANY Lic. No. F Class Contractor's Address Contractor's E-mail Address City State r— Zip �— Telephoner— SETBACKS REAR SETBACKS FRONT PERMIT NO. ?A (vo _,A,0 SETBACKS LEFT _ SETBACKS RIGHT PLAN CHECK NO. r� USE ZONE DEVELOPMENT NO 'yt 07,1 PLAN CHECK FEES $