HomeMy WebLinkAboutX2021-2875 - Permit Application (2)Print Form ;g Worksheet for Combo Building & Solar Per t Application
r Comm'I Residential City of Newport Beach - Building Div 1.0-10
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding [ Grading [—,Drainage [ Elec
Address (Not
M5 5 (A) ria l lea plied
[ Mech Plum Cu Yd
Flood f— Fire F- Liq r Landslide
Remodel SF
OWNER'S NAME Last I First
Cu Yd Fill
[N/A Floor Suite No
F77 F -
Use Const Type F
# StoriesF # Units (if Res)
--
Valuation $
F7777I Material/Labor WWVV
Owner's Address Owner's E-mail Address
.. - -- -- --
City State Zip �— Telephoned
APPLICANT'S NAME Last
Applicant's Address
City State
First
Applicant's E-mail Address
Zip F. Telephonel __ - - -—
ARCHITECT/DESIGNER'S NAME Last First I Lic. No F7_777
Architect/Designer's Address
City State F
Architect/Designer's E-mail Address
Zip �— Telephoned
ENGINEER'S NAME Last First Lic. No.F_
Engineer's Address
- _ _ _
City State I
Engineer's E-mail Address
Zip F— Telephone7—
CONTRACTOR'S NAME/COMPANY Lic. No. Classy
Contractor's Address Contractor's E-mail Address
City State F Zip F_ Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. )C2O Z ( Z C 7 5
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. R6U71.-leg6
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $