HomeMy WebLinkAboutX2021-0642 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
{Building F_Grading rDrainage j-Elec j-Mech F_ Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) [_ Flood I== Fire F_ Liq F- Landslide f N/A Floor Suite No
Description of Work
Use ConstType
#Sto&eq:,� # Units (if Res)1_
'�FtT►27 ((L2 i.t.is iulTi-E ">— I�i LLC�I�"� G'-i__� t C.L7ZUij
Valuation
New/Add SF Remodel SF F Garage/New/Add F—
Material/Labor
OWNER'S NAME Last 3 2,0 L L e, First
Owner's Address Owner's E-mail Address
A 0. QUX 2 2 c'( 2 k
City Ww_5a &�i�:w State 7 zip — Telephon 7t4) 313 a 3 0-9
APPLICANT'S NAME Last C>' 20z o First 1 5
Applicant's Address Applicant's E-mail Address
Z522 Cth�vL!(;�! s, irto, 3-,-Ttoo Ydt —ig 1}^G C eAcJ&Eu . Nirj
City r'['�57t A( State Gi4. Zip QZ� `6� Telephone 7 i4.3Ct3 (; 3 O3
ARCHITECT/DESIGNER'S NAME Last C.')(�2Cp First �l.� 1 Lic. No.
Architect/Designer's Address Architect/DesignersE-mail Address
5 f l (-�Ga a,
City � State Zip r— Telephoned—
—
ENGINEER'S NAME Last 4y(zo%) First r (a- A441►+JS Lic.NoF
Engineer's Address Engineer's E-mail Address
4-774- Ayrzaso G Al o ,roitit
City I C&A"wS State F CA Zip q 07p3 Telephone 02-)4t3 (947
CONTRACTOR'S NAME/COMPANY �C) 5 �� Lic No. '37 (.Gm Class
Contractor's Address Contractor's E-mail Address
City •% (t-q FL- State -W ' Zip Fcl Z� 14- Telephone 71¢ 3 C( 3 O,`3 0-1
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
- �1dl0