HomeMy WebLinkAboutX2021-2791 - Permit Application (2)Worksheet for Combo Building & Solar Permit 4W( -
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City of Newport Beach - Building Division z
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading rDrainage KElec j�Mech ryPlum Cu Yd cuts Cu Yd Fill
Project Address (Not mailing address) F Flood F_ Fire F_ Liq r Landslide rN/A Floor Suite No
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Desrrinfinn of Wnrk
New/Add SF Remodel SF��
OWNER'S NAME Last
LCwVQ..- IRLIWIARY UseFP3', Const Type j�._5
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pL-n 4tL P*M 6gW TO # Stories', # Units (if Res)s
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Valuation $
Garage/New/Add Material/Labor 98 S
First
E4 C N k Mt,
Owner's Address Owner's E-mail Address
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City �t ._ Riff-) .. State Co Zip -.. -.
-- (civ'' - (��io Telephone 4'�c-h9;�7-6878
APPLICANT'S NAME Last I
Applicant's Address
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city I CiAGvi A lit(o State
ARCHITECT/DESIGNER'S NAME Last tCCcy
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Applicant's E-mail Address
I iU11XJ V(XA-204, 94
Zip 3 Telephone Cii-_1;7?a=/),IO
First (7J9U,D Lic. No. CZZ 40L/
Architect/Designees Address Architect/Designer's E-mail Address
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city F(JAL�.. ��� ....... ' State —' Zip QZ 3 Telephone 9149 _ --734650
ENGINEER'S NAME Last �", IL W First x7 Lic. No. ceJ_7S3
Engineer's Address w Engineer's E-mail Address
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City Cfl-(;C)nJA _..)4tt Lj State Cj9- Zip - Telephone 11 fY11erid. -
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Lic. No. F'5—Class
Contractor's E-mail Address
State F Zip [_ Telephoner—
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $