HomeMy WebLinkAboutX2021-2106 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
d Rr
Comm'I Residential City of Newport Beach - Building Division
��C
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL C9</FOQ�P
F-Building F Grading
F-Drainage I_ Elec F_ Mech f- Plum cuvdCut F cuvdFill
Project Address (No ailing address) Flood Fire Liq j Landslide I N/A Floor Suite No
Description of Work
Use Const Type
7.
A \ �C_ RCAD) I K) EA C_/ DJ_
#Stories #Units (if Res
4A
A ►i jj jj � ,f'j�
e v
Valuation $ l41
Material/Labor r���
New/Add SF � ��
Remodel SF �� Garage/New/Add ��
OWNER'S NAME
Last A '< First
Owner's Address
Owner's E-mail Address
City N EQ PCw i
(7L_AC_ 1 State FcA Zip Telephone
APPLICANT'S N E
Last ��� First
'T\
Applicant's Addr ss
Applicant's E-mail Address
jd•A-.cmv�
- -
City I
State F Zip IY Telephoned a51
ARCHITECT/DESIGNER'S NAME Last_ Firstw- St4��_ Lic. No.'iy
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City
State Zip Telephoned
ENGINEER'S NAME
Last O 'CQ (j N E L L First K V I N Lic. No. S L{ f] 0'7
/
Engineer's Address
Engineer's E-mail Address
1150 S_Dc_fVE
ST, SvfTE 1,6b0 KP0C0WJELL SGH• CCM
City I L-d S A M C7 E� L j� State CA Zip Do (5 Telephone �•13-271- k� j1-
CONTRACTOR'S NAME/COMPANY Lic. No. Z Class
Contractor's Address
Contractor's E-mail Address
City
State Zip Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $