HomeMy WebLinkAboutPV2021-208 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Ap-pfic �iolli w
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building [-Grading [—Drainage rElec [-Meth r; Plum Cu Yd cut' Cu Yd Fllll
Project Address (Not mailing address) [I Flood Fire [- Liq [- Landslide FN/A Floor Suite No
1201 Outrigger Dr. Newport Beach, CA 92625
of Work
Use ConstTypeFj
JRMAQ FT ystem, ane cro Tve s.:171 .0ad Center. # Storiesf — # Units (if Res)
J
New/Add Sd Remodel SFF-77-77Garage/New/Add
OWNER'S NAME Last
First
Owner's Address Owner's E-mail Address
1201 Outrigger Dr. �
City Newport Beach State CA
Zip 92625 Telephone 949-50I 0-973a
APPLICANT'S NAME Last (Andrews First ISanto
Applicant's Address
10713 Norwalk Blvd.
City Santa Fe Springs State CA
Applicant's E-mail Address
isanto.andrews@sempersolaris.com
Zip 90670 Telephone 714-404-5063
ARCHITECT/DESIGNER'S NAME Last�—
First
Architect/Designer's Address
-_. __.
City I State
Lic. No. I
Architect/Designer's E-mail Address
Zip Telephoned—�
ENGINEER'S NAME Last First-' Lic. No.
Engineer's Address
City ,� State
Engineer's E-mail Address
Zip Telephone—��
CONTRACTOR'S NAME/COMPANY Semper Solaris Lic. No. 975152 ClassB,C10,b'
Contractor's Address
10713 Norwalk Blvd.
City Santa Fe Springs State CA
SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USEZONE DEVELOPMENT NO
Contractor's E-mail Address
Zip 90670 Telephone619-715-4054
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $