HomeMy WebLinkAboutX2021-1809 - Permit Application (2)Print Form 9 Worksheet for Combo Building & Solar Permit Application
Comm'I CX Residential
City of Newport Beach - Building DivisionnX
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI L
FX -Building (X Grading
fXjDrainage fX-; Elec FXMech FK- Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) FXTI Flood fX Fire [X- rX- Landslide rXN/A Floor Suite No
]bob ()la.; rn
Descriptionof Work
Use F_ Const Type F_
#Stories #Units (if Res)
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Valuation $
Material/Labor
New/Add SFF ---�
Remodel SFF— Garage/New/Add F__—',
OWNER'S NAME
LastJi l First Iry
— t�
Owner's Address
Owner's E-mail Address
i� Pow,
YARV 6m --E
City
,-State r✓6 Zip F— Telephone 9i�-
APPLICANT'S NAME
Last `V First
Applicant's Address
Applicant's E-mail Address
City)VLO& p.-_ State ��,�- Zip G � Telephone 71<(
11
ARCHITECT/DESIGNER'S NAME Last W�I I v � b k � rst I Lic. No.
Architect/Designer's Address
Architesigner's E-mail Address
City
State F Zip I— Telephone—
ENGINEER'S NAME
Last First Lic. NoF
Engineer's Address
Engineer's E-mail Address
City
—
State F® Zip F-- TelephoneF
CONTRACTOR'S NAME/COMPANY i L01 Lic. No. 1 Gq x^16 i Class
U'.jer .1,1 � 3 a %
Contractor's Address
Contractor's E-mail Address
City �1 t7 __
State 1 c,,�- Zip �j Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN
USE ZONE
DEVELOPMENT NO PLAN C "Q$