HomeMy WebLinkAboutPV2021-198 - Permit ApplicationFeint dorm Worksheet for Combo Building & Solar Permit Application o�EW�-
F_ Comm'I Residential City of Newport Beach - Building Division q�j%�� r
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL vol..,
rBuilding r Grading rDrainage rElec rMech r Plum Cu Yd Cut F Cu Yd Fin
Project Address (Not mailing address) F_ Flood r Fire rj Liq F_ Landslide rN/A Floor Suite No
Description of Work
Use ConstType
' I K00 C6 501x, - 01,
#Units (if R
# Stories es)
S";0� �Q'�5 3 5 W�
Valuation $
Material/Labo )
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New/Add SF� Remodel SF� j
Garage/New/Add I
OWNER'S NAME Last 1 i0�(,�'0. First
Owner's Address Owner's E-mail Address
( �t a-\
-Ave,
City b J- T- � State 5� Zip 6d15Telephone
1
APPLICANT'S NAME Last First ZJ
Applicant's Address Applicant's E-mail Address
�tOgS G ��A O'0-�Y.�c. pVA- ��- 7Gc.�•:sl.o.r(�uvepe���e�<vb/�S��sol�.-:eco-,.
City �. %� State 1 D Zip d �U�- Telephone 1.
ARCHITECT/DESIGNER'S NAME Last First
_ Lic. No. F__',
Architect/Designer's Address Architect/Designees E-mail Address
City State Zip Telephonel—
ENGINEER'S NAME Last First �', Lic. No..
Engineer's Address Engineer's E-mail Address
City State F Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY z5Ur`Ia` So� ] G� 1 Lic No. �(,5; j9 Class F',
Contractor's Address Contractor'sE-mail Address
L� _ Gl�- �^ t / Zar .sV.a�ti3L r��pv�e�f��5�So1rr.Gc,
City I State Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
�E ZONE DEVELOPMENT NO .O W U L PLAN CHECK FEES $