HomeMy WebLinkAboutX2021-1767 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 07-Riz�
Comm I ResidentialCity of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F Grading [—Drainage r Elec Mech
r Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood
F— Fire r Liq r" Landslide F_N/A Floor Suite No
90 �I/\a(A fsle
I I
Description of Work
Use F—ConstType F_
De -✓✓I L)
r !7
r I� 0
S r R
# Stories # Units (if Re5)1—
Valuation $
New/Add SF�— Remodel SFF-— Garage/New/Add
F
Material/Labor
OWNER'S NAME Last FAn' CO lLI
First
Owner's Address
Owner's E-mail Address
V v r ��G1 IS Le
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n
City nC4�l^ State C(f}
f wLast �' I�
Zip Telephone
APPLICANT'S NAME
First FF
y U
Applicant's Address
Applicant's E-mail Address
()I 5 1P
PlaiiI(AA C 6,C 1nC C0v'-1
City State Cn
1
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last �— First F Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F—
Zip I Telephone
ENGINEER'S NAME Last �—
First F_ Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City �-.---� State I—
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY rn L
'l
Lic. No. �G}-�6�� Class
Contractor's ddress
Contractor's E-mail Address
Jul )'p C� "yf!
City �,I1 �/,� CGl J State FCA—
Zip �1 6 33 Telephone � q 7 '1 fl � o I
L I
SETBACKS REAR SETBACKS FRONT
`.
PERMIT NO. ./ q �,I L1
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 0`1 -ZU�`
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $