HomeMy WebLinkAboutX2021-1194 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application 2a .M
City of Newport Beach - Building Division X 202A �`� 1 '� 1
[- Comm'I � Residential g
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
SCBuilding [Grading [—Drainage Alec r—MechPlum Cu yd Cut Cu Yd Fill
Project Address (Not mailing address) [- Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
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Description of Work
Use F�, Const Type
#StoriesT # Units (if Res)[—
OL S INSTHLt NEW 4001,
th } �L Ib FT
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New/Add SFr— Remodel SFF
Garage/New/Add
Valuation $
Material/Labor200to00
OWNER'S NAME Last �Kr�
First G-Ne.1sfT�v'+�'
Owner's Address �fP1lJC%Cj�G�
Owner's E-mail Address
2ofln _SANTLeiCGto tib-
CityFwt WPOfL*T brc;eU' State _C -Pr Zip rci2Vakoo Telephone--- ---.-. __.
APPLICANT'S NAME Last
First ScNoV-,f%k
Applicant's Address
Applicant's E-mail Address
LUVb Vick $olovla,
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City State
Suxl Clexv�axi� e I C�
Zi Telephone
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ARCHITECT/DESIGNER'S NAME Last First F Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City _ _._ State F
Zip r------. Telephone- ----'.
ENGINEER'S NAME Last TIND<ilL
First (1Epq(-I� LIC. No. rgc)21
Engineer's Address
Engineer's E-mail Address
33�S.EM1(zA�or _P e s -TE, 20-1
City I PNR"et M _ _ State _ r- (A ,. _ .
Zip c12$hjl¢ Telephone 94M 2.22'61los _....
CONTRACTOR'S NAME/COMPANY CA1;rn;�^D
"J1
Lic No. ciigb-ia Class 1G -V3
Contractor's Address
Contractor's E-mail Address
I0 5P�V_C-WA
GOrrrl4,a,_e CaQi m• n , t.p rv7
City �R.•�IV.S�- _ State Fcs _
Zip q21 I Telephone 9.+q 2&Sbto4Z
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $