HomeMy WebLinkAboutF2021-0445 - Permit Applicationfint Form Worksheet for Combo Building & Solar Permit Application Wes,
:omm'I r Residential City of Newport Beach - Building Division _
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
oBuilding 7 Grading F-Drainage [_ Elec F_ Mech l�
r Plum Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing address) F_ Flood [_ Fire F Liq F_ Landslide FN/A Floor Suite No
26 332 I L,ZJi/'C- t-_)r1
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Description of Work
Use Const T F_
YPe
# Stories # Units (if Res)F
Valuation S
Material/Labor
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j �J iX}L L k] J 2 ( f�lGaL-� //V L 2 -/2
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* `�—
New/Add SF�— Remodel SF
Gara a/New/Add F
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OWNER'S NAME Last ��� z�ti
First 1 U)/I"-r-4-
Owner's Address
Owner's E-mail Address
7144/L eeqj
City i�%1KY`l/ 011 r ✓> State T Zip 4L
�Ltv�d Telephone 's 7 .
APPLICANT'S NAME Last FF Jtr—
First J�?l' 1 kZ�4
Applicant's Address
Applicant's E-mail Address
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%� < c�S CC- C� /( Oe ; tf
City ��(�.{-yt+. State
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zip�2- e6 I Telephone i9/`>
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ARCHITECT/DESIGNER'S NAME Last
First �— Lic. F�
No.
Architect/Designer's Address
Architect/Designers E-mail Address
City State —
Zip F— Telephones--
ENGINEER'S NAME Last
First F Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State F
Zip �— Telephone[
CONTRACTOR'S NAME/COMPANY J ) (4S� �Class�
CYL<YC�a�2 Lic. No. O
Contractor's Address
Contractor's E-mail Address
J o 1 I i
City VILL;<I- - n�•L State FO
Zip Telephone ' /C���g._ -71-7.2
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �ZflZ(/l.r S
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 222'7 - to?,(
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $