HomeMy WebLinkAboutX2021-1892 - Permit Application (2)Print For Worksheet for Combo Building & Solar PermitAt licdo �
F- Comm'I f- Residential City of Newport Beach - Building Division to,
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building r Grading rDrainage r Elec Mach r Plum Cu Yd Cuts Cu Yd Fill
Project Address (Not mailing address) F_ Flood r- Fire F_ Liq F_ Landslide FN/A Floor Suite No
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Description of Work
Uses {onst Type
# Stories7 # Units (if Res)s
Valuation $
Material/Labor
New/Add SFr— Remodel SFF — Garage/New/Add F —
OWNER'S NAME Last �� First
Owner's Address Owner's E-mail Address
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City CDVD✓ja_CiPSP ViAR-it— State 5ETZip `"1 Z(P2 Telephone2j.G q g63r0
APPLICANT'S NAME Last C-6 1-j Firsts
Applicant's Address Applicant's E-mail Address
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City N/� (JG Ta.�i _ r� �� State Zip `%' "Z6 `F� Telephone Q/`(:g 5 -o -,Z5 .(I lS.....
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F_'
Architect/Designer's Address Architect/Designer's E-mail Address
City _ State F— Zip F_ Telephoner
ENGINEER'S NAME Last First F Lic. No.F_'
Engineer's Address Engineer's E-mail Address
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City _ State F Zip �— Telephone
CONTRACTOR'S NAME/COMPANY ��J a �` Lic No. $2f3t, Class
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Contractor's Address Contractor's E-mail Address
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City I L�k t4 rt/]- State �K Zip F0 TelephoneF
SETBACKS REAR �_ SETBACKS FRONT PERMIT N0.
SETBACKS LEFT _may SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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