HomeMy WebLinkAboutX2021-3445 - Permit ApplicationWork et for Combo Building & Solar Peitlication z4�`""°��
F_ Comm'I r- Residential / City of Newport Beach -Building Division X� V �jc l�
f NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTA✓,") c.�.�w.�
F -Building F-, Grading
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Project Address (Not mailing address) F_ Flood r Fire (i Liq r Landslide JN/A Floor Suite No
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Description of Work
Use F— Const Type F-1
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# Stories # Units (if Res)
$
Material/Labor
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G/Valuation
New/Add SF
Remodel SF �— Garage/New/Add'
OWNER'S NAME
Last a bur (/I P .[�U/� II! First L C) ey�✓L /-FS15GC .USf��.
Owner's Address
Owner's E-mail Address
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City
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APPLICANT'S NAME
LastJ
I First JIM rVta
Applicant's Address
Applicant's E-mail Address
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City
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State Cis— Zip 92-7d� Telephone
ARCHITECT/DESIGNER'S NAME Last First r�I
- Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
_. State �- Zip F Telephones
ENGINEER'S NAME
Last Lo\ ,.L � 5 V� �Dt S�� 9 First Lic. No. ', _
Engineer's Address
Engineer's E-mail Address f, 3
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- State C� Zip �� I ` Telephon % )��) (I 3 �_�ig
CONTRACTOR'S NAME/COMPANY G P 12- L J) S�VU v d ^ Lic No. 5-Z (pRZ Class f}-
Contractor's Address
Contractor's E-mail Address l
city S n- Ari -,
_. State Zip _. �1Z-7 b Si Telephoner,[(/ ,..
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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