HomeMy WebLinkAboutX2021-1490 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application SO
r Comm'I ( Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing` F_ Flood r Fire r- Liq j" Landslide F_N/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)T
Valuation
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New/Add SF
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OWNER'S NAME
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Owner's Address
Owner's E-mail Address
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City N UC
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APPLICANT'S NAME
Last (, �,�(� First �i�11�
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Applicant's Address
Applicant's E-mail Address
City fc 5i trA
State I Ems_ Zip T27 05 Telephone T 1 304 7
ARCHITECT/DESIGNER'S NAME Last I First Lic No. �—
Architect/Designer's Address
AP,ram LCA' t-TT Architect/Designer's E-mail Address
City I
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State — Zip F— Telephone[
ENGINEER'S NAME
Last l V First I Lic. No.F
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Engineer's Address
Engineer's E-mail Address
City
State F Zip F Telephoned
CONTRACTOR'S NAME/COMPANY j\ V� t' /�tj /b�� ^ ` Lic No. G1gq,; Class
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Contractor's Address
Contractors
City -1'G14
State � Zip ��- Telephone[
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SETBACK�`ffS' REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $