HomeMy WebLinkAboutX2021-3225 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application naw
Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUEATTiMF r)PciianniTTci
Building r Grading
Drainage p<Elec >ech m CuvdCut CuYdFill
Project Address (Not mailing address) F_ Flood F Fire F- Liq Landsfide N/A Floor 1 Suite No
Description of Work
Use St,LConstType ,,/_�
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# StoriesT # Units (if Res)
Valuation /
Material/Labor
bor /
New/Add SF (. 7 1
.3/�
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Remodel SF �` Garage/New/Add—
OWNER'S NAME
Last IAA-rl&I First T{ 4P
Owner's Address
Owner's E-mail Address
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/L�� / G �/�G [.'., A �r r1 e AF^;7 C�=t-`Crn-7
City
State Zip G 7�;� Telephone 7" Z` if
APPLICANT'S NAME
Last �C}L L�j First Zf../ C-.-
Applicant's Address
Applicant's E-mail Address
L 12 '/ C01s r
H�L,X, s L-li Fir i
City f'.pl %
State �— Zip Z G Zj Telephone `T 6'37
ARCHITECT/DESIGNER'S NAME
LastFs_ tv;r �/ First F— Lic. No. P - s.¢If-�.r,
Architect/Designer's Address
Architect/Designer's E-mail Address
City [—
State �- Zip [ Telephone
NGINEER'S NAME
Last FoP E5 First io g "
ff LC Lic No. G- 7 o c'
Engineer's Address
Engineer's E-mail Address
' r; I'f7n{� r i�id'7 -
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City f/1 /" % /F. �i %�)
q
State F — Zip �' �'.'�, / Telephone-]'t�--i� • t,- f�
CONTRACTOR'S NAME/COMPANY f � �CVL t) � ME f Lic No. '�} S� Z Class
Contractor's Address
Contractor's E-mail Address .�LS—(7g6
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City �—
State �— Zip[_ Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. , ,C��-)
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ -/