HomeMy WebLinkAboutX2021-2368 - Permit Application&Solar Permit Application
Print Form Worksheet for Combo Building ach Building Division
City of Newp
ES DUE AT TIME OF SUBMITTAL
Comml j -Residential NOTE- PLAN CHECK FEcu Yd Fill
N/A Floor Suite No
Elec' Mach r Plum Cu Yd cut
Grading Drainage r
wilding Flood r Fire r Liq r Landslide
Project Address (Not ailing address)
iti ff` jj `_ �a 1ti
I «}vsL.:t Const Type'
_[ � � � _�` _ Use
Description of Work # Stories # Units (if Res)7
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--- Valuation$
-51
-..-_ -- Material/Labor
New/ SF �_-
Remodel SF�- Garage/New/Add F
First
OWNER'SNAME Lastl covoktaAo jo I'ik !TI_
Owner's E-mail Address
Owner's Address 20 b
PP t �e r
ttC++ -_tt� p"A Pd State e zip _q'�5 -- Telephoned
City Nc_ it,la45-- 9t viGk ^n
First
APPLICANT'S NAME Last La _ ad'a K Applicant's E/-'�mail Address
Applicant's Address�dfv+yLdCcWr �� QcIG VE'S�[yec�iGY�_• «__
I RIPJe� Telephone qS1. 6, M . 44137
State Zip
D1ry lK� [Sivrry Z6,$ �1
First �%gyH.2w� Lic. No. C 3 -
ARCHITECTIDESIGNER'SNAME Last C�Sa� _
ArchitecUDesigner's E-mail Address
ArchitecUDesigner's Address
_.
hLv�rC t _ Telephone ✓/q. 4(,S ,_§�2410
1`71& Lr0 c�
State al_i Zip
city I �VV, ityot- 2vcL�
First 9V
V � pf t o Lic. Na. t j s 1)
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ENGINEER'S NAME Last O Y 4 1 Z
T Engineer's E-mail Address
r174
r s Address
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\� vU. (Ttc�e(tc -�' Zip ��67 Telephone �/�,7%7 //t(i^
State (:
ity Q(aKf°E' 1 Lic.No. 33463qClass
TRACTOR'S NAME/COMPANY AAS
1 Address
Address
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State C'
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Contractor s E -mai
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% Telephone 1s"(. -i'7 l_, 5
Zip a
23�c�
PERMIT NO. XZ� 'LO7�1
PLAN CHECK NO. �l-1
PLAN CHECK FEES $