HomeMy WebLinkAboutX2021-1515 - Permit Applicationx2o2L -(,5Iv
Print Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I V Residential City of Newport Beach - Building Division [AVRA"
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
5f Building r Grading
rDrainage 5t Elec rMech (— Plum CuvdcutF Cu yd Fill
Project Address (Not mailing address) r Flood r. Fire rLiq r Landslide rN/A Floor Suite No
260 Cagney Lane Unit 217
Descri tion of Work
ping
Use Const Type �B
ew ig
U
v u
# Storiesf— # Units (if Res)
Valuation
New/Add SF�.
Remodel SFr
Garage/New/Add F
$
MateriaUtabor 2 t 65u
OWNER'S NAME
Last avis
First iane
Owner's Address
Owner's E-mail Address
1800 Pitcairn Drive
City lCosta Mesa
State FA Zip 2626 Telephone 949-291-5740
APPLICANrSNAME
Lass Foolbert
First raig
Applicant's Address
Applicant's E-mail Address
622 Littler Drive
houses@gmail.com
City HB
State CFA
Zap F649 Telephone 14-856-2605
ARCHITECT/DESIGNER'S NAME Last loolbert
First Fralg Lic. No.
AmhitectlDesigner's Address
Architect/Designer's E-mail Address
622 Littler Drive
dhouses@gmail.com
City HB
State FA
Zip F2649 Telephone 14-856-2605
ENGINEER'S NAME
Last han
First Fibert Lic. No. -61343
Engineer's Address
Engineer's E-mail Address
13104 Glen Ct.
City Chino Hills -----
State CA
Zip, 1709 Telephone 09-591-2468
CONTRACTOR'S NAMEKOMPANY
Lic. No. r Class F_
Contractor's Address
Contractor's E-mail Address
Gty F—
State r
Zip Telephoner
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. H I, O� I "/✓�
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $ O '