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HomeMy WebLinkAboutX2021-2362 - Permit Application (2)Pnnt Form;,, Worksheet for Combo Building & Solar Permit Application r-Comm'I JIF Residential City of Newport Beach - Building Division XWF;Z,VZ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building Grading rDrainage Elec F_ Mach r- Plum cu Yd curl QYd Fill Project Address (Not mailing address) C Flood r Fire F_ Liq F_ Landslide FN/A Floor Suite No �ii_LS�U�i2c�t1�}-I �EiJJPa�-t•' 'j��/ F_- Description Work Use F_ Const Type Rer � l , AN>Z) h00a-S n� t� © # Stories # Units (if Res)[— es)[.....-. �� ........ Valuation $ �"/ °' Material/Labor III���--- New/Add SF � Remodel SF�- Garage/New/Add I tp `>�� OWNER'S NAME LastL'-f�Nx First Owner's Address Owner's E-mail Address � �IJZ ..... City State l Zip (Telephone�— APPLICANT'S NAME LastnjC/�J� (' First llg� Applicant's Address Applicant's E-mail Address < ! 1� ..._�1rE17�1t(4 J7G%JJv - K-.!�LCoriZj aui:7 tm� ' iF City StateCt4 Zip Telephone + A� 5—s—, e ARCHITECT/DESIGNER'S NAME Last First —'' Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State F— Zip r Telephones ENGINEER'S NAME Last First Lic. No. Engineer's Address Engineer's E-mail Address City State F_ Zip Telephoned CONTRACTOR'S NAME/COMPANY '� � t2(3CTia Lic. No. 53Zi_OZ90ass� Contractor's Address Contractor's E-mail Address 16>5 $ (LPP,-�.iCL'�_r-"j(_ —(cJ ?'7C)— G�Y�m,Cy State �—ZipC2C3Telephone oly''f`��ys��`7 / City �e✓rr.(� .._ SETBACKS REAR SETBACKS FRONT PERMIT N0. ->C ?L_,O2 ( Z>6� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Zoy7 - e� USE ZONE DEVELOPMENT NO PLAN CHECK FEES $