HomeMy WebLinkAboutX2021-0788 - Permit ApplicationPrint Form WoyKt eet for Combo Building & Solar Permit Application
r Comm'I F- Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building Grading rainage F_ Elec r Mech
r Plum Cu vd Cut[_ Cu Yd Fill
Project Address (Not mailing address) I- Flood
r Fire F- Liq r Landslide FN/A Floor Suite No
-20No",!ily', L"
Description of Work
Use constType V-B
# Stories #Units (if Res)
aluation $
Material/Labor
fJ
New/Add SF �— Remodel SF C / j(s Garage/New/Add �—
OWNER'S NAME Last M rb� Firsts c D T
Owner's Address
Owner's E-mail Address
3?:,6C
City State C q
ZipF_7F_T VO 6 TelephoneF
APPLICANT'S NAME Last
First I J, \ i O
Applicant's Address
Applicant's E-mail Address
//!�ZG 2 V,,,//,e- 1�1�
;� \ o
City FIT k-4- State C A Zip Gil 3 Z Telephone SG 2
ARCHITECT/DESIGNER'S NAME Last
First F Lic. No. �—
Architect/Designees Address
Architect/Designer's E-mail Address
City State
Zip Telephoned
ENGINEER'S NAME Last I
First Lic No.�
Engineer's Address
Engineer's - at Address'y ^�
City State F
Telephoned
CONTRACTOR'S NAME/COMPANY
N11Y1 Conskruc}t'o
Lic. No. `}29(a02 Class GIO'G�•
A1tWF6Rr bL #6T3 °050473
Contractor's Address
Contractor's E-mail Address
10042 Noel *eel,Suik III
m-frc0ns<FrRC I'on.C.om
City (_OS ftiami}p5 State I �T
Zip 0I0720 Telephone q-b-T1 -5i Ob
1
SETBACKS REAR 6 SETBACKS FRONT -20 PERMIT NO.
SETBACKS LEFT (� t SETBACKS RIGHT
` PLAN CHECK N0.%-
-
USE ZONE DEVELOPMENT NO
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PLAN CHECK FEES $
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