Loading...
HomeMy WebLinkAboutX2021-1511 - Permit Application (2)Print Form .� Worksheet for Combo Building & Solar Permit Application Comm'I f7 Residential City of Newport Beach - Building Division �.� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT A [Building (-Grading rDrainage (-Flet F,_Mech (-;Plum Cu yd Cut Cu Yd Fill Address (Not mailing address) F Flood Fire F-, Liq F_ Landslide F_N/A Floor Suite No L I N a © 7,� Q� r - Description of Work Use F7 Const Type r- 'RE-fAIDpt=L (<t —t t_k4f-'N t LSA. -T-14 #StoriesF_ # Units (if Res)F_ C 4 AN H to 50 n.t i JV t N t7. o wS Valuation $ New/Add SF F77777 Remodel SFF77777 Gara a/New/Add F' Material/Labor F777 OWNER'S NAME Last I kA AS? s f -t A.t_L First Owner's Address Owner's E-mail Address - 3k 4__ - I.-A-K)J I> o City StateCW Zip o 2 , it ( TelephoneF APPLICANT'S NAME Last Applicant's Address -- - _ .. ..... - City I State �— First Applicant's E-mail Address - .-_... --- Zip � Telephonel-� ARCHITECT/DESIGNER'S NAME Last First Lic. No . F77777 Architect/Designer's Address -.. --_ City [_ State r Architect/Designer's E-mail Address - - -- Zip F Telephone�— ENGINEER'S NAME Last F First Lic. No.� Engineer's Address City State r—� Engineer's E-mail Address - - _- -- - -- Zip �— Telephone�— CONTRACTOR'S NAME/COMPANY Cp _Lic. No. 5t 363 Classri _ MCC 1��2Y CONSTIZ_UoT(Dr�] Contractor's Address \uk-S tc t��tJ PLW L� City Cosi 1 MtzS1� State C4 SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's E-mail Address CPMZDNC Z.�C-tMLIfL .L�I./f Zip cjZG Z-7 Telephone L°I2-0 Q511 I1glulii�Na PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $