HomeMy WebLinkAboutX2021-3278 - Permit ApplicationPrint Form I Wor�sh for Combo Building & Solar Permit Application �'` °A'a
(- Comm'I F_ Residential ((JJ City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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# Stories # Units (if Res)
Valuation 5
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New/Add SF� Remodel SFF— Garage/New/Add
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Material/Labor !
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last I _CDA44—
First
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last �,1_. First Lic. No. k=.�T7e>
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last Y/ j - R.' 0 First i?L Lic. No.F
Engineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAMEKOMPANY C�y�IJZ'PQ3�.( fps ��^+� Lic No. ClassF_
Contractor's Address
Contractor's E-mail Address
City State F_
Zip F_ TelephoneF— r1
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $