HomeMy WebLinkAboutX2021-1452 - Permit Applicationn Worksheet for Combo Building & Solar Permit Application
\ dy of Newport Beach - Building Division
F Residential(_ �� , --MnTF PLAN f64fX$5jAQUE AT TIME OF SUBMITTAL
,iding T'pGrading )rDrainage,�Elec r Mech
Project Address (Not
._z
of Work
New/Add SFI0/` Remodel SF
OWNER'S NAME Last II^ C_2
Owner's Address
CX-,L'V
City State F—
APPLICANT'S NAME Last I �-�y� , 4--ice
Applicant's Address
' c S-r 2Z
City State
r" Fire r- Liq f-
Cu Yd Fill I r/ _)
F-N/A Floor J LLLSuite No
Use �-�ConstType
#Stories #Units (if Res)Fi
Valuation $
Material/Labor /�i7"iJ
First I )
Owner's E-mail Address
ipe @ �rvvha i i • Cil'IN_--•
Zip Telephone --
Firstly-, ,
Applicant's E-mail Address
Zip Telephone ( s-3 (p
ARCHITECT/DESIGNER'S NAME Last I � r �First
Architect/Designer's Address Architect/Designers E-mail Address
City State �— Zip r-- Telephonef --
ENGINEER'S NAME LastO
Engineer's Address
City
CONTRACTOR'S NAME/COMPANY
Contractor's Address
city
^, SETBACKS REAR
SETBACKS LEFT
1, \ USE ZONE
Lic. No.
First : Lic•N°.)n r;f•�.-,
Engineer's -m it Address
State [— ZIP �-- Telephonef —
vr
n arFv� LIc.No. T,b-1+
State F— ZIP
Contractors E-mail Address
TelephoneF�
SETBACKS FRONT PERMIT NO,
SETBACKS RIGHT PLAN CHECK NO.
t
DEVELOPMENT NO PLAN CHECK FEES $