HomeMy WebLinkAboutX2021-3273 - Permit ApplicationPrint Form _
- Worksheet for Combo Building & Solar ermit[Applicat on
F Comm'I Residential City of Newport Beach - Building Division p
NOTE: PLAN CHECK FEES DUE AT TIME OF SI IRRAITTni
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Project Address (Not mailing address) Flood ( Fire Liq j ndslide
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Description of Work
New/Add SF
OWNER'S NA
Hpplicant's Address
City
ARCHITECT/DESIGNER'S NAME
Last
Arch itect/Designer's Address
City
ENGINEER'S NAME
Last
Engineer's Address
Cu Yd Fill
N/A Floor
Suite
Use Const Type
#Stories # Units (if Res)
i
Remodel SFF_— — Garage/New/Add Valuation $
Material/Labor
ME Last �.._._.��`'
I-V--% A_111� First �dV��
Owner's Address �✓
Owner's E-mail Address
City l' C� Aov
NCB l y �JC,Cs� �,y Stater CA y '0 lti ty �+, C'r1V i,`J1t9v��.E�cas l`..eK
Zip %Z—Telephone
APPLICANT'S NAME &
ZJ ` Last
First I
Applicant's E-mail Address
Zip Telephone � � Z1
State I C
First
Arch itect/Designer's E-mail Address
State 1� Zip
Telephone
First
Engineer's E-mail Address
Lic. No.
Lic. No.
City
State Zip Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. �,1'5 ClassF'�
Contractor's Address
Contractor's E-mail Address
_ \V,s� si l ''�"1',y
Zip Telephone
City State �
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT N
SETBACKS RIGHT O. Z0Z ` _ 32.7_�
'JSE ZONE PLAN CHECK NO. I�VZI Ct��
DEVELOPMENT NO PLAN CHECK FEES $ t j 5q, S 1