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HomeMy WebLinkAboutX2021-0688 - Permit ApplicationPrint Foam Worksheet for Combo Building & Solar Permit Application r Comml `Residential City of Newport Beach - Building Division OTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F-Building F_ Grading bbrair Project Address (Not maili 15 �� aroccm '�Iv Description of Work R�f�10 15' aj 2_9 Elec j— Mech F - Plum Cu address) C' Flood UI w Ir Cu Yd Fill Fire [ Liq [i Landslide FN/A Floor Suite N( F-- s— {{'' Use F—ConstType I— I Iv # Stories # Units (if Res)F— New/AddSF! Remodel SF �d Valuation$ Garage/New/Add Material/Labor /•� OWNER'S NAME Last Owner's Address city —_ State APPLICANT'S NAME Last Applicant's Address City Qj State ARCHITECT/DESIGNER'S NAME Owner's E-mail Address Zip Applicant's E-mail Address t a OYI—�� Zip 2_ Telephone .. I Last First Architect/Designees Address City State I Lic. No. I— Architect/Designer's E-mail Address Zip Telephone ENGINEER'S NAME Last First Lic. NoT— Engineer's Address Engineer's E-mail Address City - -- —_� State F_ Zip Telephone CONTRACTOR'S NAME/COMPANY r � ic.No. j Class �s Contractors s — Contractor's E-mail Address l ►1n CC City NPR State Zip Telephone --- SETBACKS REAR SETBACKS LEFT USE ZONE SETBACKS FRONT SETBACKS RIGHT PERMIT NO. X2�1 - OCOZ PLAN CHECK NO. 2!!eM - - o DEVELOPMENT NO PLAN CHECK FEES $