HomeMy WebLinkAboutX2021-0212 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application
City of Newport Beach - Building Division
Comm'I Ff'Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F Grading F-Drainage F- Elec
Proiect Address I
of Work
IrE':i�`
New/Add SF 1T%1 Remodel SF
OWNER'S NAME Last
Owner's Address
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City (L' � '. - ' , 717
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APPLICANTS NAME Last
F_ Mech r Plum cu Yd Cut Cu Yd Fill
r Flood F Fire F_ Liq F- Landslide r_N/A Floor Suite No
C
Il_
Use F_ ConstTypeF
# Stories? # Units (if Res)F_
Valuation$ /�A'�
Garage/New/Add 1.7_1 Material/Labor ((I'yW //
Lj I Ir,s,t'1"First
Owner's E-mail Address
Telephone ` (-
State Zip F- ° C j 1 ; J'
l First
Applicant's E-mail Address
Applicant's Address l
76
city ;,�'r /� i 1, .'I (� f { State / Zip %)1_ /�
Telephone i i� L
ARCHITECT/DESIGNER'S NAME Last First F — Lic. No. �—
Architect/Designer's Address Architect/Designees E-mail Address
State �v ?iP �— Telephone[
City pp
ENGINEER'S NAME Last V4 U j/C I -I T
"i I/z First Lic. No.
Engineer's Address
P
City -
CONTRACTOR'S NAME/COMPANY
Contractor's Address }
City l: 1�.'
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Engineer's` E-mail Address
oe. Q7 1 111 l'� f' j. (,
i'
Zip a_ i Telephone cl
State
� �=1 P (G' -
i Lic. No. ' I k' Class , C- �`�
C '� C
Contractor's E-mail Address
m r „
State �I Zip �'(� (� TelephoneFt `'� - 1-1 711
SETBACKS FRONT PERMIT NO. -J
SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO - owPLAN CHECK FEES $
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