HomeMy WebLinkAboutX2021-1666 - Permit ApplicationPrint Fprm Worksheet for Combo wilding & Solar Permit A plication
City of Newport Beach - Building Division�r'u� a -
F Comm'I F' Residential M! ,,,, IuECK FEES ni IF nT TIKAF OF RI IRMITTAL ° o
rBuilding r Grading [-Drainage lec F*ech
Plum Cu Yd cuT Cu Yd Fill
Project Address (Not mailing address) 7_ Flood
j- Fire r Liq F_ Landslide F -N/A Fl�oorr]� Suite No
Or
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Work
Use Const Type
Description of
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0 i L', �= i:I Li`l - n �i`iIrr GLhS/7 h�l�f I r��17.0 . # StoriesO Units (if Res)
Valuation $
New/Add SFI Remodel SFF?Ao �. Garage/New/Add �- Material/Labor `- -
OWNER'S hJA^AE Lastly :eT j _1/v71y,-- First --
Owner's Address
Owners E-mail Address -
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City �Z G�(1�1/ State �.
Zip Cr L'�'J! Telephone ' 4 _'%C%.
APPLICANT'S NAME Last�(J.l j
First
Applicant's Address ff
Applicant's E-mail Address
City ��/ J-'�s,Af��. State C�, `
Zip.. �i' _,t- j Telephone �:'�-'t� - 1 �� %i ilii
First—
ARCHITECT/DESIGNER'S NAME Last -' ��U Lic. No. G �iS
Architect/Designer's Address -.
Architect/Designer's E-mail Address
City '�f'- 1�p� j�(State -
Zip �1 �,�' r,h/ Telephone � � �''- t Ur .�' t'� ?•
ENGINEER'S NAME Last
First �— Lic IVoF
Engineer's Address
Engineer's E-mail Address
City F—.. State
Zip �- TelephoneF—
CONTRACTOR'S NAME/COMPANY I 'cjkaW 16Qv Lic No. 016 / Class
I l
Contractor's Address
�LL1nvU�vc�y - \\
Contractor's E-mail Address
raw(j I e.ctllnmwtrt7l 1�US,L0
City NC State �
Zip �7 (� _ Telephone
SETBACKS REAR SETBACKS FRONT 1 PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N0-_-�`-,'`' W
USE ZONE DEVEW IyP�
PLAN CHECK FEES $
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