HomeMy WebLinkAboutX2021-2821 - Permit Applicationermt Fore: Worksheet for Combo Building & Solar Permit Application
Comm'I F_ Residential City of Newport Beach - Building Division x MID • Zq Z�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding (! Grading
[-,Drainage r Elec Mech r Plum Cu Yd Cut F Cu Yd Fin
Project Address (Not mailing address) r- Flood r- Fire r7 Liq F, Landslide FN/A Floors Suite No
1la(ai, --Gan--
l- gZ46C� !tom ��
Description of Work
_
Use [_____7'-GbnstType St$�
# Stories # Units (if Res)s
0. nu 2k 3 Feu '
t N IIu M
D I cz3 S. ;,z ATM scirroLmAs
New/Add SF
_. -—,
Remodel SF i— Garage/New/Add a/New/Add
g
Valuation $ e
Material/Labor
OWNER'S NAME
Last First
Owner's Address
TM AP- Cori, Owner's E-mail Address
-II0 _InnOV't4On
O QPQ et�S+E\N L� �CVt1�PS0Yh
City =r vl n e�
State �� Zip 9zC— ) r -r Telephone C19q
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
! LL SWIG, }1u,tl i ►x�02n
_I �ertr~;t+- W �Il; ams S� n. cry vvv�-
city s ,Yyv y\&�
State r Zip ii%� Telephone / I01 / ao�-530
I U1
ARCHITECT/DESIGNER'S NAME Last �han_1 I �C
First&l
G 171 SI Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
! `7319 S�n lPedre tat/ Loa,.0_6w l 421,
City
�ll
State I / ` Zip ►�gZ3 2 Telephone CZ53�33Sws3
ENGINEER'S NAME NIP
Last First F Lic. No. '
Engineer's Address
Engineer's E-mail Address
City
State F Zip Telephoned
CONTRACTOR'S NAME/COMPANY
Irl ✓1 , ,t 11,1 n rn Lic. No. ZIP 2 ,Class Cy iJ
l.• ,•U
t--m-aiill
Contractor's Address
Contractor's Address
LII Sou4l, /iftrr�r
Ls+
City I Or(DnC
_
0 State �m Zip (o(i Telephone(g0fj �2Z�53t
SETBACKS REAR
SETBACKS FRONT PERMIT NO. X Z(DZO — ZSZI
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. '2� l/ J �� Z-0,7-0
USE ZONE
DEVELOPMENT NO VZ,01b —bctSS PLAN CHECK FEES $