HomeMy WebLinkAboutX2021-0275 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Perm 021ica2oli "se
F_ Comm'I F_Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SIJRMITTAI
j -Building F-GradingF-Drainage
rElec F_Mech F -Plum CuvdCut cuvdFill
Address (Not mailing address) F,_ Flood r Fire r Liq F- Landslide FN/AII— Floor Suite No
Project
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Description of Work
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#Stories #Units (if Res)
60 c,
Valuation $
Material/Labor
New/Add SFF_F_50-- Remodel SF 1��(5__
Garage/New/Add ',
OWNER'S NAME
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First a
Owner's Address
Owner's E-mail Address
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City 's \/� State
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APPLICANT'S NAME
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First j
Applicant's Address
Applicant's E-mail `Address
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State `Ir_Ov_ k
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CHITECT/DESIGNER'S NAME 1 A� �c
Last ��� 0.v Cr First Lic. No.
Architect/Designer's Address
Architect/Designer's E -mai Address
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GI�N?EER'S NAME
Last y
First Lic. NoF
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Engineer's Address
Engineer's
city
State I—'
Zip r— Telephone(
CONTRACTOR'S NAME/COMPANYk6L CZ �A 1 ,tr /6�� Lic. No. 1���j�(�{ Class
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Contractor's Address
Contractors E-mail Address
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KS REAR
SETBACKS FRONT
PERMIT NO.
E
I00;70
SETBACKS RIGHT
PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES $