HomeMy WebLinkAboutX2021-1949 - Permit Applicationx10111-V14q
11 Pint Foam Worksheet for Combo Building & Solar Perm pplication
F_ Comm'I r Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `'<.ow�•'
'Building F_Grading rDrainage i-Elec rMech F -Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire F- Liq r Landslide [_N/A Floor Suite No
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Description of Work
Use Const Type
# StoriesFtL # Units (if Res)
Z '4404 / ®'
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Valuation $
Material/Labor Z/
New/Add SF Remodel SF
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age/New/Add �
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OWNER'S NAME Last Brtc
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F st /VJ(i✓ tsr / K�vIA�
Owner's Address
Owner's E-mail Address
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City C(»fG.� G.6�G5 _. _ State _._.r.�
Zip 33�1 136/ Telephone
APPLICANT'S NAME Last v,.,,!'
First I -r;;t4.,6ey-
Applicant's Address V
Applicant's E-mail Address
tSto Acnes G./c,
City tYM'!�U �I�t!Lwh State 1 4�
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Zip ///r� U/ '.. Telephone 9j;/; 7.�" 70&)
ARCHITECT/DESIGNER'S NAME Last G(ili•z ICL_ _ _ First NJG„,�� Lic. No. F_..
Architect/Designer's Address
Architect/Designer's E-mail Address
13*2�1�4 P11-r4_e,,,•J
City / /(11�GvtV i/cv e� State F —e -A
Zip l?,zo3 Telephone ZcrZ'�iJ�O
Last � g1,rf �t n,*o �
ENGINEER'S NAME 9 r LF.� V `o'
FirsY � �1�, Lic No.�
Address
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6,— -5 u�!
Engineer's
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Engineer's' E-mail Address
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City State F_
Zip F TelephoneF_
CONTRACTOR'S NAME/COMPANY /G v� T� C
L
Lic. No. toI1 q/ 'Class 3
Contractor's Address
Contractor's E-mail Address
07J7Co PL w•,4•l0 ��
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City /CGrr,4 v CGGG.wr�+� C State 4
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Zip ��%v� Telephone /s�z `J"�`d'•7l�CG
SETBACKS REARSETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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