HomeMy WebLinkAboutX2021-3301 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit ApplicationoF�6'°Ra
� Comm'I r Residential City of Newport Beach - Building Division X -EC2.j {�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ,,P
(XX Building Grading FX;Drainage r Elec FX7 Mech r Plum Cu Yd Cut Cu rd Fill �
Project Address (Not mailing address) F Flood FX_ Fire rX_ Liq r Landslide VN/A Floor Suite No
775 AVOCA-DD AVL, COgo Aur A D6-7- More, GR 9262 -775' _
30
Description of Work
Use F—ConstType r_
# Stories # Units (if Resf —
Valuation$
Material/Labor 3B �
--.-_- IZS
New/Add SF Remodel SF
Garage/New/Add r
OWNER'S NAME Last.SHlf%ZV'AA/J
First HN41V
Owner's Address
Owner's E-mail Address
—77_S AVOC&PO AVC
H5997� S SC6ca F3ia L.Av�TT
City I cjgON4+ vwz, M.i-e, State I ""' ZiP 472eo_zFTelephone 202-90b 88®8
APPLICANT'S NAME fast
First ffj wfp
Applicant's Address
Applicant's E-mail Address
-7%57 /aVQC*Vo AvE. _
N591A9,s8e4ztoaA1,.NB7*
City I C40)2®n!A b$L AM 7,' State
ZipRiiZs Telephone 202-gAD,9 e&B
ARCHITECT/DESIGNER'S NAME Last First r— —�
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
-
City I State F
Zip r -- Telephoner— —
ENGINEER'S NAME Last7101 E D
First j A Nl Lic: No. '7SB Bey.
Engineer's Address
Engineer's E-mail Address
386F2 1-1I� 3'�.
SM®�3��N�eK�lc'wan�•t'oBtj
City I IZt/11V6- State
Zip gTi4 l Telephone 3lQ _435 7AW
CONTRACTOR'S NAME/COMPANY
Lic: No. �� Class ri
Contractor's Address
Contractors E-mail Address
City State L-'---
Zip r— Telephone
SETBACKS REAR SETBACKS FRONT
�4 u
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. T
USE ZONE nP%Irl nDRACKIT Ail
11 .1i n. 1r 1 ____ .e