HomeMy WebLinkAboutX2021-2349 - Permit Application (2).;'-Worksheet for Conibo Buil diri Solar Permit Application
F, Comm'I F7 Residential City of Newport Beach -Building Division UO2.1— ZM
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F]'BuIlding [71 Grading [,-_Drainagej Elec EMach Plum Cu yd Cut
Cu Yd Fil
Project
Address (Not mailing address) C Flood El Fire 7, Liq [—I, Landslide F7N/A Floor Suite No
W -W y tv ------
Description of Work
Use Const Type
q-0 # to #Units (if Res)FT
Valuation $
New/Add SF Remodel SF Garage/New/Add Material/Labo 7t 40,0
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
[_2Ao_V_1e-,vfkjr4 L j
_e
City [WOWPO r -t State Zip Telephonel Lalq 6)
Ff 47
APPLICANrS NAME Lastl /gr/jR ), „ First
Applicant's Address
[2 -w -
city FN�;77(—F4 State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designees Address
City State
Applicants E-mail Address
Zip Telephonel 3j0—f26'_?-)—q0
First
Lic. No. F77777
Architect/Designer's E-mail Address
Zip F Telephone[77--
ENGINEEWS NAME Last First Lic. No.
Engineer's Address
City State
Engineers E-mail Address
Zip Telephone[ ---- — ---------
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No.
USE ZONE._ CHECK FEES
_DEVELOPMENT NO