HomeMy WebLinkAboutX2021-0763 - Permit ApplicationX I 0 7 6 3 2Q 3 at PGAC4
PrintForm Worksheet for Combo Building & Solar Permit Application EWA e
City of Newport Beach Building Division 3
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Description of Work
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OWNER'S NAME - Last11ni
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Owner's Address Owners E-mail Address
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APPLICANT'S NAME Last T. pi, EOlSBdO eVX jQ First
Applicant'sAddress Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last /�., hj First4 \ o'Vtl��.1 Lic. No .
Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last First r ` l Lic.NoT �— —
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY 7-�T Lic. No. ?3 Class
Contractor's Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. U7 43
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. (77 t) )- Z0'1�
USE ZONE DEVELOPMENT NO PLAN GHFCK FFFS 1 Gt 5� - 0"