HomeMy WebLinkAboutX2021-1014 - Permit Applicationj`--Pf1ht1F6rm 'I WorksMet W'Colffllbo Building & Solar Perknit itid 04
F_ Comm'l F- Residential City of Newport Beach - Building Division 'I , - z
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r -Building F_ Grading [-Drainage r- Elec F7 Mech F- Plum Cu Yd cuts Cu Yd Fill
Project Address (Not mailing address) F_ Flood f- Fire [_ Liq F- Landslide [N/A Floor Suite No
Description of Work
Use Const Type
# Stories # Units (if Res)F2
F
A ,Pv
INTO/V5
Valuation $
Material/Labor
New/Add SF Remodel SF FT Garage/New/Add F
OWNER'S NAME LastI First 'JEr_r0bv5F_14) I ,
Owners Address Owners E-mail Address
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City I g%mqw %4-eA7 State Zip Telephoneo
APPLICANT'S NAME Last First
Applicants Address Applicant's E-mail Address
City State F_ Zip F Telephoned
ARCHITECT/DESIGNER'S NAME Last I IvPIR61,f N FirstV-0"
I Lic. No.
Architect/Designers Address Architect/Designer's E-mail Address
1 MONTA 4! 1 JTM)4jRCH/_MCT_ 611141L, a
State Fl?'—IT zip Telephone
City I W, 1�-� 1 7/,� 7
ENGINEER'S NAME Last First F_ Lic. No.F-
Engineer's Address Engineers E-mail Address
City State zip Telephone
F F
CONTRACTOR'S NAME/COMPANY Lic. No. Class F
Contractors Address Contractors E-mail Address
City State [_ Zip [_ Telephoned
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $