HomeMy WebLinkAboutX2021-2233 - Permit Application„ri 'trn Worksheet forComboBuilding & Solar Permit Application
r Comm I �; Residential X2�ZI'?'�3 % City of Newport Beach -Building Division ?/ flu '/2 15j, 5 V
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building f-1 Grading Drainage (yElec F_MechPlum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire F-; Liq F Landslide FIN/A Floor Suite No
Description of Work r .� � � # Seorie� .Cons Units f R�
# U is ( Res)
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All
SF ;;5 Remodel Sr _�j_ Garage/New/Add Materi
dal/Labo
OWNER'S NAME Last l/��?� First ��arofY_ ,
Owner's Address - 'J-7 _ Owner's E-mail Address
City /�/ __ __ state C7� Zi _.. ._.j Telephone 9�3Z/S'7
APPLICANT'S NAMELast Applicants
Applicant's Address �G. ��_--- �nt's E-mail Address
City __ State �li Zip�l Telephone—!
ARCHITECT/DESIGNER'S NAME LastiI/ First'I Lic. No.
i
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last,1/ A First Lic. No.
Engineer's Address = - Engineer's E-mail Address
City State—! Zip Telephone
CONTRACTOR'S NAME/COMPANY 1] Lic. No. F-- ClassF
Contractor's Address Contractor's E-mail Address
City State F Zip F Telephone',
SETBACKS REAR Z SETBACKS FRONT PERMIT NO.
SETBACKS LEFT 7 SETBACKS RIGHT ( ( PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $