HomeMy WebLinkAboutPV2021-168 - Permit Application1 11
Print Form ; `,I Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential Clt�,of Newport Beach -Building Division Y 7)i iW o
.NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r– Grading F–Drainage FElec --r Mech FPI'um Cu Yd Cut Cu Yd Fill
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Project Address (Not mailing address) CFlood r Fire F–', Liq F_ Landslide (-N/A Floor Suite No
I/ Ty l Plau,,Dei/ Sup/ P&vparb&M, CA 9 � F_ F-.
Description of Work W H AIP'o
Use - Const Type Y
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REQ - G l/ /Vh7000 6 6 �i I Zo U
# Stories' # Units (if Res)[
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Valuation$ FT,
Material/Labor
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New/Add SF Z G �, Remodel SF F Garage/New/Add F
OWNER'S NAME Last �lr/ First Idelff
Owner's Address Owner's E-mail Address
l ,?qI p[&T0eQD� swr �efF Paradsca e -/Vo,
City /t/ off' �% h State T/9- Zip q / Telephone
APPLICANT'S NAME Last la'rMV_\.a06 First!
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Applicant's Address Applicant's E-mail Address
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City � % fa /I CLC State Zip 47,9TO_5 Telephone 'lsgOjrS–c_e6d,_)
ARCHITECT/DESIGNER'S NAME Last –/WX /� First .� Lic. No. __�
Architect/Designees Address Architect/Designer' -mail Address
City State F Zip F— Telephone[
ENGINEER'S NAME Last / � First � 4 Lic. No. C66F7
Engineer's Address Engineer's E-mail Address
City � State F— Zip F— Telephoned—'
CONTRACTOR'S NAME/COMPANY p �} 11� G%74. _/ � Lic. No. j}�!�/f�(� Class C �1j
(% l/r/ �! LCoontractor'r'ss
Contractor's Address E! -mail Address
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City 4ne/ State I UW Zip ff_�J_�q5 Telephone Wi73'715- _G 7, q
SETBACKS REAR SETBACKS FRONT PERMIT NO. � UlU
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. IOU u l
ry /�
USE ZONE DEVELOPMENT NO YI I/U I U h ' U 4 PLAN CHECK FEES $