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HomeMy WebLinkAboutX2021-1569 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Perm t I ation s - Jo?EW�Re F— Comm'I F_ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTA taloa" rBuilding F_ Grading F -Drainage FIElec 1IMech F- Plum cuvdcut F CuvdFill F Project Address address) C' Flood F- Fire F_.Liq F_ Landslide FN/A Floor Suite No s((Not �mailing `70 7U- 1 Al�-(ISOL J AVE, Description of Work Use [_ Const Type #Stories #Units (if Res)� T_02.,5 r (,':5Q1/kM LQi.) lS tR PZWZ- `bsp",&D Valuation SF New/Add SFF--Remodel SFI—Garage/New/Add�Material/LaaborF6, OWNER'S NAME Last First Owner's Address Owner's E-mail Address Q6 7r=A � _i���.► � CCN City I tj.CcoPyLV.-BCAC, State FL N Zip�� Telephone -... APPLICANT'S NAME Last W'z„ . ... _... First I t ,(_/ Applicant's Address I Applicant's E-mail Address ZB�3 2 S tOZ/2 p /C_ &Ws �- XA00LEI3ACC.Q�a�Etv/J1YleVT,e6AC_ City �Il- Ck�i CM ?80 State rv"� Zip Q�Z/* Telephone 9 clQ gQ,�.—/(S/� ARCHITECT/DESIGNER'S NAME Last((/ First `/ Lic. No. r-- Architect/Designer's Address ArchiteoUDesigner's E-mail Address City .._. .. State ---- Zip I ---I Telephone ENGINEER'S NAME Last —rTbd%PS First ]"jAtj) W Lic. No.1 0&55 II Engineer's Address Engineer's E-mail Address ©a1 F.AJt 1df�Qrs% ;rAX. City .. _ State I-------.— Zip F Telephone CONTRACTOR'S NAME/COMPANY' l Lic. No. 47612 Class � Contractor's Address Contractor's E-mail Address `Z,n32 S / , PC—Ax, c r -t—,-"&5II1Ac 1304'r )0=4"04MCOAk Cityl{CCi CAUc CA) State f --, Zip �`,� Telephone rjy� s16/Old SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ DZd Z I - 033