HomeMy WebLinkAboutX2021-1290 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division x Lot ire
(-•••. Comm'I F Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building [Grading rDrainage F_Elec rMech
F-PlumCu Yd cut Cu Yd Fill
Project Address (Not mailing
address) F_ Flood
r Fire F- Liq r Landslide F_N/A Floor Suite No
� 5 l \ d rG12a-\C 6
Description of Work
Use F Const Type F
# Stories #Units (if Res)
Y�� �(1 GP 2
_.. _
_..
Valuation $
New/Add SF� Remodel SFF®-- Garag a/New/Add F
Material/Labor F5;z. _._.
OWNER'S NAME Last
�Y �Z
First WI��
Owner's Address
Owner's E-mail Address
t.� G aA
)6116YCL f�Or
City I Y\.2W-fOV'4' J.eAC'.I'1
State Zip (DoTelephone cq17 g8Z�.___
APPLICANT'S NAME Last
First kocLv,
Applicant's Address
Applicant's E-mail Address
Cs-L�e7 Ik S��jQ.
�-�-�
pr7pe�Vi,�i+-sem `I.loyZ.,
City 1:;
State Zip
)31�7 Telephone
ARCHITECT/DESIGNER'S NAME
Last _ First Fr-----..
Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City I —
State F Zip
F_ Telephone-.
ENGINEER'S NAME Last
_ _
_ First F Lic. No.
Engineers Address
Engineer's E-mail Address
City _
State F__ Zip
I TelephoneF
CONTRACTOR'S NAME/COMPANY
pro S+ao-
TT
Lic. No. fps%6j Classy
Contractor's Address
Contractor's E-mail Address
c��c2 vev-\,�tkl-e� twa
City F_
State F Zip
F_ Telephoner ---
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
R