HomeMy WebLinkAboutX2021-1809 - Permit ApplicationPrint Form; A Worksheet for Combo Building & Solar Permiplication ��� °�
FX_ Comm'I F, Residential City of Newport Beach - Building Divisionx �'�q a
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT L
f,Building r Grading
r'Drainage r, Elec FX_ F>-< Plum Cu Yd Cut F Cu Yd Fill F
Project Address (Not mailing address) (x' Flood r Fire X Liq F, Landslide F�<_N/A Floor Suite No
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DescriptionofWork
Use Const Type �
#Stories # Units (if Res)
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Valuation $
Material/Labor
New/Add SF�;
Remodel SF�!, Garage/New/Add �,
OWNER'S NAME
Last First 11v
Owner's Address
Owner's E-mail Address
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City 0M(-
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.(J ��,a,',�LState �' Zip Telephone
APPLICANT'S NAME
LastrFirst
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1
Applicant's Address
Applicant's E-mail Address `
City / T - p State �- Zip C'�a4 Telephone 7
ARCHITECT/DESIGNER'S NAME ,'I/I 1^ Lic. No.
—_ Last VV V 6I � V 0 ` , first .
V
Architect/Designer's Address
Archite esigner's E-mail Address
City
State F_ Zip F- Telephone'
ENGINEER'S NAME
Last First Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State Zip Telephoned
CONTRACTOR'S NAME/COMPANYLic. No. Class
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Contractor's Address
Contractor's E-mail Address
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City
KI 7
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State �/` vrr ,/w'_- ZipI Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN
USE ZONF
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