HomeMy WebLinkAboutPV2021-013 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application som
j— Comm'I r Residential City of Newport Beach - Building Division 81 1 I _ 0 p,3 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT
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Building r— Grading
F.—Drainage r,Elec rMech f—plumcuvdCut F cuvdFiuF—
Project Address (Not mailing address) r- Flood j— Fire j— Liq r— Landslide CN/A Floor Suite No
2611 Crestview Dr
F F—
Description of Work
Use F Const Type r
# Stories # Units (if Res)
KOOT mount(;: rizzlu
e sys em. o service upgraIle
Valuation $
Material/Labor z 60
....-.......
New/Add SF�—
Remodel SF�— Garage/New/Add �—
OWNER'S NAME
Last Nugent First Kelli & Robert
Owner's Address
Owner's E-mail Address
2611 Crestview Dr
City Newport Beach
State CA Zip 92663 Telephone949-500-9871
APPLICANT'S NAME
Last Valencia First Mary
Applicant's Address
Applicant's E-mail Address
10800 Hole Ave.
mary@designs. solar
City Riverside
State CA Zip 92505 Telephone951=236-0113
ARCHITECT/DESIGNER'S NAME Last First —Lic No.
Architect/Designer's Address
Architect/Designees E-mail Address
City �—
—
- State F_ Zip F_—. Telephone
ENGINEER'S NAME
Last F_ First ( Lic. No.F
Engineer's Address
Engineer's E-mail Address
City. - -.
State �— Zip �— Telephone— _
CONTRACTOR'S NAME/COMPANY Blalock Electric & Solar Inc Lic. No. 1 Class
Contractor's Address
Contractor's E-mail Address
23905 Clinton Keith Rd.
blalockconstruction@designs.solar
City Wildomar
State CA Zip 92595 Telephone 951-440-0583
SETBACKS REAR
SETBACKS FRONT PERMIT NO. ` 1
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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