HomeMy WebLinkAboutRev21-1495 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application_
F- Comm'I I�(Residential City of Newport Beach - Building Division Rev 2 G - i Li 0 b
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading
Project Address {N
F_ -Drainage rElec F_Mech F -Plum Cu yd cutI Cu Yd Fill
of Work
L - L4 30 L %
wab loo.� - a". we.
waw - torr w )6 Sara
ress) F.- Flood F_ Fire
r` Liq r Landslide
FN/A Floor
Suite No
SIN Dfrt_ Mae ,
rA.
F_
'T —TALL- IMA !?b � Use F Const Type F_
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" TALL X 14.9' LG&jggj4
x Z,g r t.6w1.%14 # Storiess # Units (if Res)s
o Valuation$ �}
New/Add SF� Remodel SF Garage/New/Add Material/Labor t 5 t 35®
OWNER'S NAME Last
JOAtti`.5 First
Owner's Address Owner's E-mail Address
20 Z°1 /•tom Sts?. J, F 0Mw P1ovT6AtALW"-1 . CO
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City Sgr�MAnn16N State �t.1A Zip 9$® - Telephone AZs) ?fa%-ZSivZZ
APPLICANT'S NAME Last [ Mpoz::r IJ
Applicant's Address
1S CO?_1P0q_ATf, PI..Aspr ®Q., 5T9_ ISE)
_..
City NEWPORT $S_AL14 State Gq
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
151 IL.f(t rAU5DQ• 5` F, Cri- I
__ _-
City C,o b" I� WSA State FEN—
Applicant's E-mail Address
1_ J05TIr-t (�-r•r>;tzsor� Ct1S�o Mo+A-ti L1.(
- -
Zip gZ(p(Q® Telephone lIA) 38u -&472 -
First s_(P _IvcLic. No
Architect/Designees E-mail Address
Zip q%(ny(p Telephone C70r) ?Sq- +o4-0
ENGINEER'S NAME Last First ; . Zt, I Lic. No f
Engineer's Address Engineer's E-mail Address
2-0052 CRMeNQ f.API�iRP.N� , STt�. Z,3; yv(Ic.L cIVrLSL�P£S. tom
City ypweJp, NI���t� State G� Zip ��P }} Telephone w;g49� 4(04- %v, -_..
CONTRACTOR'S NAME/COMPANY C.l�rST®r�/i FtOnh� Lic. No. ®211539' Class
Contractor's Address
I's CoRPotzPtTP- PLaZ,p .vim. 5T'E. teat)-
city
5oCity 46090Ri 60,VA State ( pr
SETBACKS REAR
SETBACKSLEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
Zip Telephone o44> 77,3 r 1?J®0
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $