HomeMy WebLinkAboutX2021-0887 - Permit Application1.
Print Form Worksheet for Combo Building & solar Permit Application
City of Newport Beach - Building Division /�I" ®y om
F- Comm'] r Residential `NOTE: PLAN CHECK FEES DUE ATTIMF OFSUR ITTA c.___...
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r—Building r Grading F7Drainage F_ Elec F_ Meth f— plum Cu Yd Cut l
Project Address (Not mailing address) J7 Flood r Fire j— Liq r Landslide rN/A Floor Suite No
312 LI NP4 AVFAJUE F I—
Description of Work
Use S� 5 Const Type ,
# Stories # Units (if Res)
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$ ` a/ D
Material/Labor (/ (.'
3
..Valuation
Garage/New/Add
New/Add SFss- Remodel SF � F
OWNER'S NAME Last First il?
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Owner's Address
Owner's E-mail Address
312 Ung a A V-tN'UE
City State Zip F9 �"'rAC/ j Telephone57
WV -- 705
APPLICANT'S NAME Last First
Applicant's Address Applicants E rhai!Address' °T
elepho e
City State Zip:i
:STT ,
ARCHITECT/DESIGNER'S NAME LasI(/ V First Lic. No.
Architect(Designer's Address Architect/Designer's E-mail Address
City �7///"l State I / 11 Zi f Telephone -5
/ "°tl!1 pl.� p 7/ �JI —J-77 3
ENGINEER'S NAME Last F First F_ Lic. No.7—;
Engineer's Address Engineer's E-mail Address
City State F— Zip s� Telephone
CONTRACTOR'S NAME/COMPANY gg�y C 1 A e
Lic: No. Jai S�:7ii� Classy-��,
Contractor's Address . Contractor's E-mail Address
93 QUQ_ e ati , v--t.v5
City 16 � 4�_D l State 5 Zip q�WI Telephone qfl y 141 vol
SETBACKS REAR SETBACKS FRONT PERMIT NO. X LI- 0001
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 0 °tJ 9 ryysI
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $_�