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HomeMy WebLinkAboutX2021-1101 - Permit ApplicationPint Form Worksheet for Combo Building &Solar Permit ;,�s�sncation Do, City of Newport Beach - Building Division r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r— i_ rBuilding F, Grading rDrainage [Elec Address (Not mailing of Work Y fkOPc S I. S - New/Add SF Remodel SFI r,Mech j -Plum cuvdCut I CuvdFill I Flood Fire r, Liq r, Landslide r—N/A Floor _ Suite Use Const Type' # StoriesF # Units (if Res) _. _Valuation $ �r ®0 Material/Labor - OWNER'S NAME Last �� !e `` r� First Owner's Address Owner's E-mail Address Cai L - L�JfvPx9ti akLq_ �^f��_'� �\�e� �_ d State City ""� f' ��Z I v � - q Telephone — `5�� Zip lo�, First( APPLICANT'S NAME Last !�i9� Applicants Address Applicant's E-mail Address `4) SOW,_ State �— Zip IA Telephone -11y ti ��" 0a1� City � _�FiAC(ibf Firsti— Ll c. No. L��9 ARCHITECT/DESIGNER'S NAME Last �ZtkC�tL'y Architect/Designer's Address Architect/Designers E-mail Address ZiP 1 c�l'pj �. Telephone q''.^ State—, City�ror-_ �%SCk_5 F1, Lic. No. C7& 64 First ENGINEER'S NAME Last(y Engineer's Address `?or� ��t,„3cps5f�oca,,rrpG Engineer's E-mail Address p��ZiP State (�� _L,�Cov�l� --- SCP Telephone q/ C/� �c� f City �L l` `..rL.S_ Lic No. ? j J e3 7 Class CONTRACTOR'S NAME/COMPANY \ �CP�r��ad'iZAiC.•�c'�N Contractor's Address Contractor's E-mail Address I-at�� SikSYaJ—C�JS'�'� State [_ Zip ' Ic�(s� f Telephone '? 14' ` 9/0 —E321CZ), SETBACKS FRONT SETBACKS RIGHT 77-- PERMIT NO. PLAN CHECK N0. 1 DEVELOPMENT NO PLAN CHECK FEES $ �I !n/