HomeMy WebLinkAboutX2021-0957 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Alication
F Comm'I r' Residential City of Newport Beach - Building Division X20�p ica ion
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading [Drainage r Elec r Mech r Plum Cu Yd
Project Address (Not mail!
IRP 0156n Ave. NeWpor
)ascription of Work �
i?P_
r Flood (— Fire r Liq r -j Landslide
Beach CA • t12lob 0
Cu Yd Fill
rN/A Floor
Suite No
UseJ{.� A (yConst Type I v d�/
# Stories[111 j # Units (if Res)
� SR 1415 ' '� `Jg 1 s1 r4 -IV {) °i �'' valuation $ , 0 pP 6b
New/Add SF 3 q Remodel SF �, d Garage/New/Add Material/Labo
OWNER'S NAME Last/' G ,ii - - First[ Nfar1U�, f
�
_Lt
Owner's Address Owner's E-mail Address I
Ill g(Son Ave.
__ Mcinuel Gael 10 I io�rnal l • Cu✓n
qty NewUr� Bfacb State cR Zip 921�1n 0 Telehone
P . P 5bZ) (n(o5 .5532
APPLICANTS NAME Last
Applicant's Address
ill plSon Ave.
City wwvurt i�zach State FCpr
Firstl_ Ivlarluel
Applicant's E-mail Address
rfiamlel W 10 1! i-lotma; l • Coal
zip c1LL06O Telephone Se1) tob5° 553
ARCHITECT/DESIGNER'S NAME Last 3 d g j W 1_ First M L9 $} o f of Lic. No. 3753
Architect/Designer's Address
Lo01 pgr_kCern er _Dr. 6TC2o4
City I San IA Anok State FA
Architect/Designer's E-mail Address
m b (D mb/arc6oin.Cowl
Zip Fq2 005 Telephone I'�-,13I
ENGINEER'S NAME Last H A CE First Hai-} ham Lic. No. (y 33,5°1
Engineer's Address
X11 N. 1bro_tUursj ST. Suii2 222
city (;y�gh�m State Gpr
Engineer's E-mail Address
in{o��artciA5A1nC Colrrl
Zip g2g01 Telephone 114) 230 Ins
CONTRACTOR'S NAME/COMPANY P I—C 6u i i d t rS T h c-. Lic. No. 18 a 5n ClassFE
Contractor's Address
1019 Llo1s Alwy�+s BNA .STE -101.cit)'_ tos "foiml+Ds StateCit....
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
}ri�k�cllcbu;Iclersinc_._corrl__ I
Zip Q6'1a-0 Telephone5&2) U6(o•111,1
PERMIT NO.
PLAN CHECK
PLAN CHECK FEES $