HomeMy WebLinkAboutX2021-1114 - Permit ApplicationX201-1114
Print For '; Worksheet for Combo Building & Solar Permit Application 00,
I— Comm'I [7 Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood F_ Fire [_ Liq F_ Landslide FN/A Floor Suite No
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Description of Work
Use [_ Const Type F_
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#Stories[— #Units(tfRes)F—
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Valuation $
Material/Labor
New/Add SFF — Remodel S`FF — Garage/New/AddF—
OWNER'S NAME Last 4 (i11 �(S 1 G(r� i� li$ First Ff e .er
Owner's Address Owner's E-mail Address
01 56bliA f Peyer@+hepne9Yovp•C6m
City I NeWpo`(-}- BeGiC.Vi State _ CA- Zip R2(a(p0 Telephone Gy.q.gaa.�49
APPLICANT'S NAME Last V0,14Skati-�(S '., First
Applicant's Address Applicant's E-mail Address
C1 SmbluFF Peter@ H,rpnegw�(�.carn
City I tAewp0*-jP(a%.(i '.. State CPS Zip q2—( (,p Telephonegtiq.c(aaJr{j}
ARCHITECT/DESIGNER'S NAME LastU 0� f.1c�a First p�{--_r' Lic.No: G 13U
Architect/Designer's Address Architect/Designer's E-mail Address
lcoy_ tv Z"d Net Ste loo Pei-?- ctrOi1' -La nol, corn
City Vplan& State CA Zip Fq1�Bio Telephone goq..-M.115V
ENGINEER'S NAME Last l,,.qo ler- FirstRp Lic. No. (o-(pC4p
Engineer's Address Engineer's E-mail Address
120 I N . ?US-Hrn
City �ah.e 1 ySrt State CA Zipq;l ) ' Telephone' -1 t1 ,� 3o, to V�
CONTRACTOR'S NAME/COMPANY Q -rt c Va laska✓1?'115— 6wVl6'�Vlld rt' Lic. No. F—ClassF—
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Contractor's Address Contractor's E-mail Address
01 Sec( bi uF� PY)c qroup court
City I NlevipoA BeQc'i State Zip Cj2Cv( ,0 Telephone a Liq,0jaa•-��r��-
SETBACKS REAR - SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $