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HomeMy WebLinkAboutX2021-2326 - Permit Application (2)y2c)2-1— 23X2 Print Form Worksheet for Combo Building & Solar Permit Application oaEW�ae Comm] r' Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL [7Building F_GradingF-Drainage ®Elec fiMech F- Plum Cu YdCut F Cu Yd Fill Project Address (Not mailing address) r Flood r Fire r Liq F_ Landslide FN/A Floor Suite No 4cog5 WC + i�(D Deeqs�crripttii�ojn ojf�Work Use F, Const Type 1A p Inn P� i 1 /� �� ��(��I� / I,tl111 UV�I 1 UKK ' �riM�(q In 0�aMoi # Stories #Units (if Res)[ Valuation New/Add SFI :6- Remodel SF Garage/New/Add Material/Laa bor y V OWNER'S NAME Last II Vi11w W First Owner's Address Owner's E-mail Address m mmv m W. City ��`�� State I Vl ` Zip Telephonef— APPLICANT'S NAME Last l 'N� (D First CK. WI I'l. Applicant's Address Applicant's E-mail Address ZION E. WC M. WIU m 0,-Y0 MR o@oYl'0,Nn'QGU2Vta,%Gflmaw City I I' Uuw State 1 C49 Zip g2ftko Telephone ( ,Da ARCHITECT/DESIGNER'S NAME ,,q.. Last j % }' First xq t�,/ ``Lic. `5 Architect/Designer's Address Architect/Designer's E-mail Address 2100 &4�,N l P of city ,( State I C , Zip a Telephone[q4 �Licc..No. ENGINIEEI�SrIy1E Last V Mo2h(yj./� ,Uj,( First � Engineer's Address Engineer's E-mail Address 21 00 MAGMA AAV 9V noo Brno cl,r�l@ Icov� n nee�3co��, _ City F_'yiP State CP Zip �2/„�n Telephonel `6VY.W CONTRACTOR'S NAME/COMPANY N Lic. No. IOC Class t1_ ,I /- CIIN mil L Contractor's Address Contractor's E-mail Address I7?6-z 60"1411% 1>�a��KL�yCJSNyiJt L +l+°�rsTiJJ=c.o.✓I City State r_'� Zip 7Z6IV Telephone ((,,2��'ypjfj62,0G SETBACKS REAR SETBACKS FRONT PERMIT NO. i!� — lbw SETBACKS LEFT r1/ U SETBACKS RIGHT PLAN CHECK NO. _ 't' USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ z�om