HomeMy WebLinkAboutX2021-2846 - Permit ApplicationPrint Form I' Worksheet for Combo Building & Solar Permit ApplicaQLtion
F✓Comm'I F Residential NOTE: PILAN ty HECK Eof NewportES UE each -AT TIME OFing'sion SUBM2I—"��
wilding F- Grading Drainage [Elec Mech J— Plum CuvdCut CuYdFill
Project Address (Not mailing address) F_ Flood r Fire I— Liq r Landslide FN/A Floor Suite No
IMM_ 5�@riKhFaN 71. �o aIAn 3y� 7305_
New/Add SF Remodel SFF Garage/New/Add F
Use F Const Type F
# Storiesr— # Units (if Res)F—
Valuation $
Material/Labor 49
OWNER'S NAME Last First
GvrtgR4 o 504-k Ari'•1 s
Owner's Address Owner's E-mail Address
1-7 45-Sk_teat (erJeey,
City I l�-q_k6K.1 S gA VState G A Zip 9 ZS �� Telephone X55- 9 44 3 7
APPLICANT'S NAME Last 1 (j),'t r V%Uwto V
Applicant's Address
City LLat/--L5tvtvr2 State GA
First
Applicant's E-mail Address
Zip Telephone � S�4 4 3 7
ARCHITECT/DESIGNER'S NAME Last Ro VKcyo FirstQ,i Lic. No. p
EZs 0_v3-
Architect/Designer's Address
171(0.x_ 11&",1 J __5�rte%
City ITU K5 d 6t2e caC_:'t' State r C
ENGINEER'S NAME Last 10 y k
Engineer's Address
City o-fctKAe— _ State CA'
Architect/Designees E-mail Address
Zip F9
2 Telephone 7�,-.2uo
First I�D�oE✓�G LicNo.�7_
Engineer's E-mail Address
Zip Telephone 7I 497 14�
CONTRACTOR'S NAME/COMPANY AArA ge8 0x0. kOtl/ lµL. Lic. No. FwS fl, Class
Contractor's Address
z9 g" ;004 5_�v* mak
City L &;Lo �tS L oo State C�
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
Zip I ( .CJ 31 Telephone IS -1. 4-11. Zjj
PERMIT NO. XX
PLAN CHECK NO. km Au v
PLAN CHECK FEES $