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HomeMy WebLinkAboutX2021-2466 - Permit ApplicationPrint Form . Worksheet for Combo Building & Solar Permit Application j Comm'I [—.[ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X.Building ❑ Grading ODrainage Address of Work �Elec []Mech 0 plum ceYdatr— dress) C Flood ❑ Fire E] Liq r Landslide Cu Yd Fill F—JW/A�r-�Floor --�� Suite No r I# Stories # Units (if Res)�I -- — --�J / New/Add SFr Remodel SF ---Garage/New/Add RdValuation $ (07 —.___� _�� l y--Material/Lab— I OWNER'S NAME Last ' or 1I/dU0 yy J vt��tNl Fist Owner's Address _f ---- --- —J Owner's E-mail Address City — zRtlir✓� _ State Zip 9f �6t� l Telephone a�?L%nel APPLICANT'SNAME Last First Applicant's Address ------- "--------� l�1 Applicant's E-mail Address t — - MCI fit% s� �fki,cL.— State ` /t !L C Zip �J7 Telephone ARCHITECT/DESIGNER'S NAME Last _�)\ pip Firs[ 6I �� -- �--- -----�-._1/1- I Lam--- I Lic. No. 1 %' ArchitecUDesigners Address ---= Architect/Designer's E-mail Address City �� / / — — .� State L "r - it Zip q'Z 1�601 Telephone q C4 { � 1� ¢ ENGINEER'S NAME Last J First I Lic.No. r— Engineer's Address Engineers E-mail Address I City -- State I ZIP Telephone i CONTRACTOR'S NAME/COMPANY Lic. No - Contractor's Address Contractors E-mail Address City -- ------ - _ State ---..--_ _i i ZIP � Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. 6 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. r I USE ZONE DEVELOPMENT NO PLAN CHECK FEES $