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HomeMy WebLinkAboutM2021-0078 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Perml�ppp I o4�` °Re Comm'I F_ Residential City of Newport Beach - Building Division c P NOTE: PLAN CHECK FEES DUE AT TIME OF SUVAk1TTN , If-%0VQ `'%oa�•' Oi�§uilding FGrading (—Drainage F_Elec rMech rPlum cuvdcut cpuvdFiII Flood Fire Liq/rgTi�A/� Project Address (Not mailing address) oo'T Suite No " Sc>v d CITY OF NEWPORT BE�- o,r•ar, V.ta Utdo Description of Work se 'Const Type e cv+0�/2 { IC2 P� C n r S v`g pts l� # Stories # Units (if Res) New/Add SFF— Remodel SFF Garage/New/Add F Valuation$ 30 U%� Material/Labor i OWNER'S NAME Last L,��,p 151 COVI+yvWn,. _/q,%>z•First / Owner's Address Owner's E-mail Address 7111 Via, 1 -Mo ?oma( G11>0l$2,6' & C-19-AMA14— 601", City _.../V f to r -t 13eAvk State CA Zip TE_& 3 Telephone `._ �7 3 • b17v APPLICANT'S NAME LastZslLGov.,wtvv,r('t/�}SSee, First / Applicant's Address Applicant's E-mail Address 701 V A Lido Sava 1-10o 151 61iZA )vl AIz... Co Nl City New/ fp,-t- 13&A State 6f1 Zip ei (o(,3 Telephone °i_,F&1,170 ARCHITECT/DESIGNER'S NAME Last First F Lic. No. F— ArchitecUDesigner's Address Architect/Designer's E-mail Address City I State Zip F— Telephoned'. ENGINEER'S NAME Last �a�ry t/ First P10.m--, LIC. NO.G �(o`t y7 Engineer's Address Engineer's E-mail Address 2$11,1 Cotsjt,,s (ii. P. }et; -UV , FMA-M,GOvvt City I L•A/vv pa NiaJej State Z -A Zip g2(,77 Telephone 7W- 717-T017- 17.7592CONTRACTOR'S CONTRACTOR'SNAME//COMPANY SHC61mak2� roc. Lic No. 'i31 Class Contractor's Address Contractor's E-mail Address 837 W. Il tti• 5kelIM^kcr- e 6 b to 6) r,Ct City I GpSfr- 1vlt,,,,- State CA Zip 5;&11 _-7 Telephone Cqj-_Sj$•$?51 SETBACKS REAR SETBACKS FRONT PERMIT NO. kA( OZ l — C-07-14 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Qj 0( -7 - USE ZONE DEVELOPMENT NO PLAN CHECK FEES $