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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 tt \ C&Vt — --- 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) _ ENGINEER'S NAME Last O Y 4 1 Z T Engineer's E-mail Address r174 r s Address 1�c S' sSi�� •. \� 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 ee� h State C' SETBACKS FRONT SETBACKS RIGHT DEVELOPMENT NO Contractor s E -mai tt- % Telephone 1s"(. -i'7 l_, 5 Zip a 23�c� PERMIT NO. XZ� 'LO­7�1 PLAN CHECK NO. �l-1 PLAN CHECK FEES $