HomeMy WebLinkAboutX2021-3055 - Permit Application (2)Print Form 1N eet for Combo Building &Solar Permit Application °4 EWa°Re
Cit of Newport Beach - Building Division ��
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide XNIA Floor Suite No
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Description of Work s
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Remodel SF Garage/New/Add Material/La
OWNER'S NAME Last
Owner's Address
City t.,,(G (,.,[(i/{j-' (Z: State
APPLICANT'S NAME Last
Address
City
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Owner's E-mail Address
Zip Telephoned
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State 24_7 Zip
First
E-mail Address
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ARCHITECT/DESIGNER'S NAME Last
�z, i �I G 7 stI Lic. No.
Architect/Designer's Address54- Architect/Designer's E-mail Address
City State Zip Telephonel
ENGINEER'S NAME Last F-C;,Mfl I First Lic. No.
Engineer's Address
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city ir+�.QhlrL% State
Engineer's E-mail Address
Zip 927L2 Telephone %/ y s5oS • �Sr?
CONTRACTOR'S NAME/COMPANYTr- c7tiSG Lic. No. Class
Contractor's Address S--r—
City State PX-11
SETBACKS REAR
SETBACKS FRONT
Contractor's E-mail Address
Zip Z /Z4 I Telephone �y , ,5a� o • l ✓' 30
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $