HomeMy WebLinkAboutX2021-0536 - Permit Application:Rnni FoYln j : 'Worksheeffor Combo Building & Solar Per it Ap lication �tP
fi Comm'I 17 Residential City of Newport Beach - Building Division /�f�/�n/1,rU,i
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) E Flood F -I Fire F-; Liq- Landslide SIN/A Floor Suite No
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Description of Work
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#Stories #Units (if Res)
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Valuation $ f
Material/Labor
New/Add SF� Remodel SF / � � Garage/New/Add �—
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OWNER'S NAME Last dq a(/ -- First q -h q 1,000
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Owner's Address Owner's E-mail Address
City Ntv a r� i5p ael, - J State Gk Zip i (; d' ` Telephone J:f �rG
APPLICANT'S NAME Last First Ytq h
Applicant's Address Applicant's E-mail Address
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City Iv eV 0 s P -I' 13 a4 State Fu Zip "/ �4V v TF/��elephone I % f • �D''�• q" 9 1
ARCHITECT/DESIGNER'S NAME Last First 17YQ� Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address l In
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City State F_ Zip Telephone 1_11 4-3 z3 • If 3o
ENGINEER'S NAME Last First Lic. No
Engineer's Address Engineer's Email Address
City State �— Zip Telephoh9 tl! ;
CONTRACTOR'S NAME/COMPANY R (/f 4 n Ca rrs I I Lic. No. 3cisi- Class - I
Contractor's Address Contractor's E-mail Address
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City iA+Y ` / Ra a State lio - Zip f 4 � 4 TelephoneF1 (�• rVi� vi
SETBACKS REARM SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES s VS _GV, 0\ n .