HomeMy WebLinkAboutS2021-0155 - Permit Application (2)Print Form or eet for
F_ Comm'I f -Residential
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Combo Building & Solar Permit Application
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAI
0155
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Project Address (Not mailing address) r- Flood [- Fire Liq F- Landslide /A Floor Suite No
Description of Work
Use Const Type F
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Valuation$
Material/Labor W�
OWNER'S NAME Lasto
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last C7l�c�iSS First I )p
Applicant's Address - Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last cy, ev_,�4 E First C' I Lic. No. 5
Architect/Desiig^ner`'sA�ddress Architect/Designer's E-mail Address
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ENGINEER'S NAME Last First Lic No. �')
Engineer's Address Engineer's E-mail Address
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Contractors Address Contractor's Address
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SETBACKS REAR /_. SETBACKS FRONT/,1IaAdotz;. PERMIT NO.
SETBACKS LEFT (p SETBACKS RIGHTj� C9CHECK NO. t
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USE ZONE ..—.� J.U"o DEVELOPMENT ND 2.. 6 , (_J .� t��PLAN CHECK FEES $