HomeMy WebLinkAboutX2021-2863 - Permit Application (2)v•f1{1�h��/"aWorksheet for Combo Building & Solar Permit Application cr
F- Comm'I r Resil%Lv/iNewport
Eing Division
NOTE: PLAN CHECK DUE AT each - TME OF SUBMITTAL c�a
I—Building Grading ('Drainage [Flet j Mech Plum cu yd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire r- Liq Landslide I -N/A Floor Suite No
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Description of Work
Use Const Type
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#Stories #Units (if Res)
1ZE1�IGtDE L j t 2 y3A?"f RSA • T -TA x � CwDs 6r
Valuation $ 2,7
Material/Labor
New/Add SF FT 6 6 Remodel SF 74, Garage/New/Add �—
OWNER'S NAME Last I SC((NE CDE7Z First L2>% 'q
Owner's Address Owner's E-mail Address
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City);E %1•C F96ZTuE/jC&- State 4E,4 Zi Telephone
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APPLICANT'S NAME LastH05,9-r/-}(, q First (12Q D
Applicant's Address Applicant's E-mail Address
26Y95- AMD CgE6K RP, -e-1--969 _ ���o 0_WE:a£5LGq fRV-CB • 60>v\
City ��D vicjo StateFET —', Zip... y js j Telephone 323 ego _yyy c�
ARCHITECT/DESIGNER'S NAME Last 1�(pS {trRC-�6-� First �� Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
Z6`�95 Mkt so CF_r=EK P_ . fy"69 .TNFb> DES1G" PR -CH .co7.,\
City I LZSp�� State FEW Zip 9 Z O yp Telephone � 19
ENGINEER'S NAME Last SAMAD;Cq First Fqgm-vtAAJ Lic. No.
Engineer's Address Engineer's E-mail Address
City State F_ Zip F Telephone'
CONTRACTOR'S NAME/COMPANY L' : hlo. 1 u.q �j Class
I�iv�N.a d S a1K},ins a�61 �,
Contractor's Address Contract is E-mail Address
�`Ilo� ,tiF�� hie e��? klArfo �'A,O5.00�
CityG G r cla State c_& Zip � Jd c-("( Telephone
SETBAC S REAR SETBACKS FRONT PERMIT NO. %202 I -N,6 3
CK LEFT SETBACKS RIGHT PLAN CHECK NO. Z49 S 2C/Z
DEVELOPMENT NO PLAN CHECK FEES $