HomeMy WebLinkAboutPV2021-236 - Permit Application (2)Print Form I Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_. Residential City of Newport Beach - Building Division V
f NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
B_uilding r- Grading DraInagF.e F_ Elec F_ Mech Plum Cu yd cut Cu Yd Fill
7- 1
Project Address (Not mailing address) r7 Flood r-, Fire F_ Liq FLandslide F__N/A Floor Suite No
_
I F_ 77
,4 r 1A Nucry)
New/Add SFF ___ Remodel SF I Garage/New/Add F__
OWNER'S NAME Last
Owner's Address
APPLICANT'S NAME Last
Applicant's Address pp
City
State
First
Use F Const Type
#StorlesrF # Units (if Res)F--
Owner's E-mail Address
------ -------- - --- -
Zip Teiephonel__C,,4q
First
NMW
Applicant's E-mail Address
Zip F7 I 14-Telephonet -- ----
ARCHITECT/DESIGNER'S
------
ARCHITECT/DESIGNER'S NAME LastFirst Lic. No. —
. ....... ... . . .. ....
Architect/Designees Address
- --- - ---------- ----_--------------
city State
F7-
Architect/
Designer's E-mail Address
zip Telephone[_-,
ENGINEER'S NAME Last ZGGI First Lic. No.[23
Engineers Address
City State F
Engineer's E-mail Address
.. . ........ ..
Zip Telephone
CONTRACTOR'S NAME/COMPANY 3Q"�4,AA -: _17_)Jj Lic. No. [7--F7— Class —
0 Flo
Contractor's Address
A
- - ----- bbN 14T_
State
City Vnc,,
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
Contractors E-mail Address
Zlp(�t ' r l Telephone44/7 f
7q 5 (B
PERMIT
PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $