HomeMy WebLinkAboutX2021-2275 - Permit ApplicationPant Form Worksheet for Combo Building & Solar Permit Application zE
Comm'I r Residential City of Newport Beach - Building Division UO2l _ V f �/
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM AL
XBuilding n Grading rDrainage r Elec XMech r Plum Cu Yd CutF Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
100 5AYVIEW CiptL6
F_ �—
Description of Work
Use F— Const Type F'
# Stories' #Units (if Res)
KFL* EA4f,vT OF ErtSTkv6 CcosEO (!4XCa1-r 600c.lA,6 Till
W1i;U tE IN ICI1vl7 Zisweg
New/Add SFF_ Remodel SF�
Garage/New/Add I ',
Valuation $
Material/Labor �j ODO
OWNER'S NAME Last GP� 9AYI(fEly LLC First
Owner's Address
Owner's E-mail Address
Im a/I�yVI� C(itCc� z3a
City ,v5,, �T ISeaui State (A
9�(q 2S— 990 J
�luo Telephone Zip � �
APPLICANT'S NAME Last y S
First NliuS
Applicant's Address
Applicant's E-mail Address
CniYY@C44ccle. "ff-r
City J(LVI,✓Ic State
Zip gin/8 Telephone �jt(q S33—S'gS8
ARCHITECT/DESIGNER'S NAME Last
First I Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �— State F
Zip F Telephone
ENGINEER'S NAME Last a INl
FirstJJ Wao Lic. No. 5 q ZZ
Engineer's Address
Engineer's E-mail Address
c(I 5-93 WINCIAIFS7ER g$. 514176 ZOO
TAgeo @ EQuIPPRoI,.,c.coA,
City I 'TEA4ECp.1.Rl State FCAr
Zip ,?jj 0 Telephone 9 Os- 3yr-0 37�
CONTRACTOR'S NAME/COMPANY r Mtu{Z .vtErn
FN�r SYs`IEnS Lic. No. b�j ZIS Class,
Contractor's Address
Contractor's E-mail Address
2 CRo,I., "F(> L
CTt4ys IF EA1ea'A- A-E 7 -
City I IQMVIF State F—
Zip iu/,v Telephone Cqt()q Yli#-aYGO
SETBACKS REAR SETBACKS FRONT
PERMIT NO. h 61 j -411/0
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $