HomeMy WebLinkAboutX2021-1646 - Permit ApplicationPrint Form
L. worksheet for -Combo Building & Solar hermit Application
F Comm'I Residential o- f City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL n
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uilding Grading rainage XElec NMech kPlum Fo
Cu Yd CutCu Yd Fill ��Project Address (No mailing address) fFlood I— Fire r Liq J— Landslirle 5Z'N/A 1
1 loor Suite No
Description of Work
Use �3 (,(( Const Type F:ff
�Pirn�2ok. 1 �; a3 SF. � C►VT�Z,`� � v IN �C� , `� 1 ti ►� � � ICt cc1t N -
�M I I # Stories # Units (if Res)
New/Add Remodel 5F l_ Valuation $
3 Garage/New/Add �— Material/Labor �300i
OWNER'S NA Last V
/� l G�� - First
Owner's Address
Owner's E-mail Address
City �( State
Zip 2 o Telephone m VAl K 1 Ct'.Dtt t� .
APPLICANT'S NAME Last w t--
- First 1F_(CANfZ__
Applicant's Address
Applicant's E-mail Address
c,)A4 4 rcki tee
_ �CvrE'_. cam_
City � e State /� � / /
I " - ZAP �� coC� O Telephone
ARCHITECT/DESIGNER'S NAME
Last �— First
Lic. No. C Z 1 WEE
Architect/Designer's Address Architect/Designer's E-mail Address
City State
- ZIP F— Telephoned_ ,
5 8
ENGINEER'S NAME
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Last i� - - - -N `� _ First Lic. No.
- �2283
Engineer's Address Engineer's E-mail Address
City 1 i�1j N State �— Zip Telephone 6 C 3 -3
-526
CONTRACTOR'S NAME/COMPANY
_ Lic. No. F_ Class_
Contractor's Address Contractor's E-mail Address
City -- - ---..
State Zip F Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO .
PLAN CHECK FEES $,.- Z