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HomeMy WebLinkAboutPV2021-168 - Permit Application (2)Print Form, „' Worksheet for Combo Building & Solar Permit Application o°� F Comm'I Residential City!„of Newport Beach - Building Division NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5�,. N't Building r Grading r Drainage Elec - -r Mech r PIU'm Cu Yd cut Cu Yd Fill F / Project Address (Not mailing address) r Flood r Fire F7 Liq r Landslide FIN/A Floor Suite No 7-y 1 F ata-PnI,I,��fP2�ch/ CA 9 ' I , F__ Description of Work I tr V�10dUI�0 Use/ Const Type ✓"8 Ra�Fmcu�fed Pyr,, lla 17M6 16&M IPO 6- l26ndv, P5A0 # Stories' # Units (if Res) Valuation $ 1� Material/Labor 7000 1 Ce/nbirw ,5brW- ©f ftr” �irs,I's olar 6E H u5 iny kt- ,, 0 p New/Add SF Z G Q. Remodel SF �— Garage/New/Add-, OWNER'S NAME LastFirst %y) Owner's Address Owner's E-mail Address 0_0 Pwilc,/�D sr�r jefF °�'ar�(sca�®e .net City � t7�' U h State G Zip �% O�/ Telephone i,� 6 645 //a/, APPLICANT'S NAME Last mmi ft UCJ- First / Applicant's Address Applicant's E-mail Address`� 1'315 G)i/SGVr.0AV.0 -,C-71Z loa Qa9m, ie -Mpbekxr,� so% City c6-Tn f- C 47/'b% State Zip 92 fi4-5 Telephone 7S� O?5-rV6_.j ARCHITECT/DESIGNER'S NAME Last -WA" ' ' ' First Lic. No. Architect/Designer's Address Architect/Designer' -mail Address City State—, Zip �— Telephoned ENGINEER'S NAME Last First Lic. No.1 c6srT2 Engineer's Address Engineer's E-mail Address City State F_, Zip F Telephone' CONTRACTOR'S NAME/COMPANY p �{��„ . �% F`&�-� Lic. No. bj ////Ki Class C t1j /pC/�� G�/ CC•oontractor'ss C/oontrra�cctor''s E-mail Address 1Adddress na�oel-�e,6e11&-. aalCu— ' City 4n4_� State I t�� Zip R;7- _5 Telephone 9S-9 -j7 .3 -G z, 7- q SETBACKS REAR SETBACKS FRONT PERMIT N0. V Ul \� W SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 100 u v USE ZONE DEVELOPMENT NO PLAN CHECK FEES $