HomeMy WebLinkAboutX2021-2636 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
( Comm'I � Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j Building r Grading [-Drainage F_Elec r Mech ("- -Plum CuYd Cut Cu Yd Fill l
Project Address (Not mailing address) f Flood r Fire r Liq F- Landslide f_N/A Floor Suite No
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Description of Work / L j Use ConstType F
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Remodel SF�� Garage/New/Add I---
Material/Labor
New/Add SFr- ---- / 1 j
OWNER'S NAME Last G� First (J�✓ 1 t>ra F
Owner's Address Owner's E-mail Address
Z�C(e' i n p,iti�o
City State Zip J �,C 3 Telephone
APPLICANT'S NAME Last I C Cc ";, _-C First C-, r, R_>
Applicant's Address Applicant's E-mail Address
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/' �� _ ! ,C; Zi '> � v Telephone
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ARCHITkT/DESIGNER'S NAME Last F---- First r- Lic. No. r_
Architect/Designer's Address Architect/Designer's E-mail Address
City State �- Zip- Telephoner- --- —
Lic. No.j - Z
ENGINEER'S NAME Last lA 5 `c ^ 3Ui$'a'Y'//
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Engineer's Address agineer wt-mail Address
City State �. (, Zip �J� .a ✓ Telephone
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+ Lic. No. -0 Iy4 J ClassL^]
CONTRACTOR'SNAME/COMPANY
Contractor's Address Contractor's E-mail Address
City t State Zip Telephone i ` �� 121 r
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SETBACKS REAR SETBACKS FRONT PERMIT NO. -
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NIS$
USE ZONE DEVELOPMENT NO PLAN CHECK F