HomeMy WebLinkAboutX2020-2461 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application C-Sal
Print F — 9 pp
F_ Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(—Building F_ Grading
F -Drainage [ Elec F_ Mech F- Plum CuvdCut s Cu Yd Fill F
Project Address (Not mailing address) G Flood r Fire r Liq r Landslide FN/A Floor Suite No
I5(v1 Mesa_ i7Qw@.
Description of Work
Use F—ConstType I -
0M 1-29
JEVIA-C 10 411-75.
# Stories #Units (if Res)s
—
*&kStL', a
R_ Ep6q 6- 8(�.Ic.N1Fys.
R
Valuation $
Material/Labor 10s0oe
�
New/AddSFI o'
RemodelSF� Garage/New/Add —'
OWNER'S NAME LastFirst
J(�ck�!2�n1
Owner's Address
Owner's E-mail Address
_. (2121 W I LSt},
5 ,.,�Q G
� _.LFiQ2y.c..dUVcJ Aco%SoN c>.�py�r
pa.•Ce,y
City LA.
State �9
— Zip ,-723 Telephone $IIp-g�
APPLICANT'S NAME
Last i!pcflf7vG� First S' -L�L�I E
Applicant's Address
Applicant's E-mail Address
1900 5 sa,.oy
r)xkd-R. � yore s p�4cCo mac/ Mzc. cox
City Lb
State Zip 9oo2T Telephone 510 e,2? �;iL51
ARCHITECT/DESIGNER'S NAME Last 1J���� First ���� Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
^
I - loo S &A°'o-{va;: q 4400... _.. QW j_4g,B�"-.0Q.I h -2L. Goti
City I LA
State I „ Zip jC Telephone 3(e 826• Zlor-
ENGINEER'S NAME
Last vp rC IA. First �— Lic. No.F_
Engineer's Address
Engineer's E-mail Address
�
.CO'1
City ( t<wq &e ,
State � Zip 90232 Telephone 31a 314.601a
CONTRACTOR'S NAME/COMPANY Lic. NoT— Class
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip F TelephoneF_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. xZp c t✓ %H61
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $