HomeMy WebLinkAboutX2021-0827 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application ��� "� a
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Comm'I Residential City of Newport Beach - Building Division �21 Q 8 Z� � a ..9 L�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rri ,ding C', Grading CiDrainage Ck�<Iec �/Mech rk lum cu yd Cut Cu Yd Fill
Project Address (Not mailing address) CI Flood C Fire r— Liq C Landslide CN/A Floor Suite No
New'por �- C� rite r DY
ct
Description of Work ll C� c at\
Use Const Type
#Stories #Units (if Res)
Tenn{- 1m Ove/neR� Far 4 Aew Pejai S*re
on l-eVel.4 Of art
exrskir\o1 upeV\== ics�l b req— -----
Valuation $
�5
New/Add SFF_,_____j' Remodel SF 3i 2 %(p
Garage/New/Add
O
Material/Labor
OWNER'S NAME Last Vld Gfrll
_ First Vershot
Owner's Address
Owner's E-mail Address
550 Ntwq�r( stn r Dr _—_------
I vvan ani__ tr-vonC COmyhn
CityNflU�pl r &ntC/4 State�! Zip 92(/(1 U Telephone s(yH y312(a?S
APPLICANTS NAME _ - Last R\Z O
First �.CCY Cvi
Applicant's Address
Applicant's E-mail Address
il370 phare 81Vd x`330 irich�raL
@PermifadV/Bars. �� —
City State ���,
Zip RUZ )1 Telephone[7:f
ARCHITECT/DESIGNER'S NAME Last #an le L/ __— _ I First Sf i{1 Lic. No. C 3 N 1-6 j
ArchltecttDesignees Address
Architect/Designer's E-mail Address
X35 Jacksm &}reef
_ Seth@ S4Wdtob/%t2_. Curvy_
city SA11 �iR71C/SCD State Cq
-- —
Zip 9y/// j Telephone yIS 52S `d181.
ENGINEER'S NAME Last ?h i b0d�aun—_ _First Lic. No. k13$(p v?9
---
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Engineer's Address
Engineer s E-mail Address JL q
_1;345 Lenex��r+vim_54e__300--.---___—!
Chri rir ecur,henderscne�ineevs_conn __
City �Ph2Xa�__.--_._—___._--.. 'I State —KS --'.
Zip �(p21y I Telephone 913-_A -12o%
CONTRACTOR'S NAME/COMPANY —
— -- Lic No. CClassF
Contractor's Address
Contractor's E-mail Address
i
City �„ _ State ��
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p ��/�' e( r�
Zi �U Telephone e
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHEC NO. D1lc�ip• 'L'
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $-1.