HomeMy WebLinkAboutX2021-3220 - Permit Application (2)Print For_� Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F-, Residential City of Newport Beach - Building Division ocWP6220
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building (Grading Drainage [Elec rMech f -Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ FloodFire F- Liq r Landslide F_N/A Floor Suite No
Description of Work Use Const Type
771, <' 4✓!n g f /l1% East r %
#Stories # Units (if Res)
n'
New/Add SFF Remodel SF�- Garage/New/Add Material Valuatio/LabI or
NAME Last
Owner's Address
City I A1,,,1,_ fP,11 At7 J ,% State
APPLICANT'S NAME Last
Applicant's Address
City State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City [- State
ENGINEER'S NAME Last
Engineer's Address
City State F
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City State F—
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
First
Owner's E-mail Address
7
013WAMA1� i1'i'C
First
Applicant's E-mail Address
-- -
Zip r— Telephonel—
First Lic. No.
Architect/Designer's E-mail Address
Zip F TelephoneF----�-
' Lic. No. F_ Class�
Contractor's E-mail Address
Zip[—
ip[ Telephone
-zoz(• 08b8
PERMIT NO.
PLAN CHECK Nb. Z'l g S-2,0Z_f
PLAN CHECK FEES $ 3A - 6 l0 t 2