HomeMy WebLinkAboutX2020-2459 - Permit ApplicationPrint Form 11 Worksheet for Combo Building & Solar Permit A licationo�EWa°Re
F Comm'I F_ Residential City of Newport Beach - Building Division 4
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building r Grading
F -Drainage F_ Elec F_ Meth r Plum CuvdCut r cuvdFill
Project Address (Not mailing address) C Flood F Fire j- Liq (- Landslide FN/A Floor Suite No
F_
15101 Mf 5A VW04f,
.
Description of Work
Use F_' Const Type
DN get ��:° QlD EZEP I j 4114+7>-
# Stories' # Units (if Res)F
oN 6utd7 o
tZ�p�2 o S�I�,Nicys.
—
New/AddSFI �o'
�--Garage/New/Add
RemodelSFl '5 Gara a/New/Add�o-
Valuation $
Material/Labor"it 04
OWNER'S NAME
LastFirst LAiteY.
Owner's Address
Owner's E-mail Address
MI -LI W 1 LSl
5..;42 }oti LRaa42 d'Nc� wPaay -Ca K
City I LA.
State F�;— Zip Telephone so -14 94,966
APPLICANT'S NAME
Last <�7jerfl G� First S' -M j e-
Applicant's Address
Applicant's E-mail Address
190o s Gaj..oy
iJRNl4. 400 S-pni7oPg4C 4^ocl A4zc. Ce a
City (,brj 445 2
State I CA Zip 9002T Telephone 31p Co 2Z9F51
ARCHITECT/DESIGNER'S NAME Last I I,j FirstP4� :,-1 _ Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
�1
jvR
I`lOJ S g,r�p t :vq. N400 ptJrN#a f�tR+OQI Arec...C.o-S
City I LA
State Imo' zip ic,,o Telephone 316 FZ6.21oc
ENGINEER'S NAME
Last v pFr--T_ 1q, First � Lic. Nor—
Engineer's Address
Engineer's E-mail Address
(cCO-+ wp5,ti 6
••S
8[v� b�r+QelraC,2tt Fbi"L.�elnff¢ .��
City e_ 1,�G+r.
State Zip 9023Z Telephone 31D 314 •ooh
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City
State F_ .Zip F— TelephoneF_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. Z�
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $