HomeMy WebLinkAboutPV2021-045 - Permit ApplicationI Print For _0 Worksheet for Combo Building & Solar PertWi Application v saw
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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FBuilding r Grading j—Drainage F Elec r Mech r Plum Cu Yd CutF_ Cu Yd Fill F_
!Project
Address (Not mailing address) C Flood r Fire r Liq r Landslide FN/A Floor Suite No
q 63 Pr?rt PishO 6.�f ortOewd, C14 q2—(e& J 1 F—
Description of Work
Use F—Const Type SDlar
3.750xC r b)S" Siee with 12. lfanwha gW16 f 3` 0
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# StoriesF # Units (if Res)F_
Valuation Labor f/I� 5�j
Material/Labor b
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New/Add SF � Remodel SFF_ Garage/New/Add
OWNER'S NAME Last Dort First L_a wre j7 Ge-
Owner's Address Owner's E-mail Address
R 3; fort P s�%up P1
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City �' Por/ IJI�iGL�i/i ''... State GA '..., Zip �% ..Telephone
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U qwq) 286 3�1�
APPLICANT'S NAME Last 1 r°✓l
1"✓IGi"�1ltiiiA/S ! First RG4.R0c',
Applicant's Address Applicant's E-mail Address
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City
E qI State Zip Telephone -ii.�) ss,5,5ooco5
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F__ Lic. No. F_
ARCHITECT/DESIGNER'S NAME Last First
ArchitecUDesigner's Address Architect/Designer's E-mail Address
City _.. State r Zip �— Telephoner
ENGINEER'S NAME Last First �— Lic. No.1
Engineer's Address Engineer's E-mail Address2"—
City 1 State �— Zip F— Telephone
CONTRACTOR'S NAME/COMPANY .. Lic. No. Class E 10JQte pa►F�dCt' IQ;
Contractor's Address Contractor's E-mail Address
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City SaVCi� U'l(IQ State �n Zip q"() 5 �. Telephone V)37 Tq
SETBACKS REAR SETBACKS FRONT PERMIT NO.I/`]�jj�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 4; . t?a. 12,aZi
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $