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HomeMy WebLinkAboutX2021-2880 - Permit ApplicationPrint Form, Worksheet for Combo Building & Solar Perr�jt�"�cati B City of Newport Beach -Building F_ Comm'I r Residential Division _ u NOTE: PLAN CHECK FEES DUE AT TIME OF St Lv Building F_Grading Drainage F_Elec f_Mech F_ Plum cu yd Cut Cu ydFillF Project Address (Not mailing address) F Flood r Fire r Liq r Landslide F_N/A Floor Suite No New/Add SFF- Remodel SFF- OWNER'S NAME Last o5rr Mf Owner's Address Garage/New/Add First Use Const Type F # StoriesF_ # Units (if Res) Owner's E-mail Address �_3� dal,2m ✓t _ 1713 ..oSz�� bluK-t r? `yGdr-��,cvvv! i City V�/Po r' �ya State [� Zip %ZG S Telephone �/�-S!©- O i j2 /` P 7 APPLICANT'S NAME Last Applicant's Address City 1 m cl State I Z First Applicant's E-mail Address .D�k�r�senl,�u�1 � �/crGe��alo�l Zip �l�S� Telephone ARCHITECT/DESIGNER'S NAME 12 F Last J � c{e�-f' First � �t7 ,.,15 Lic. No. Architect/Designer's Address City t/f/iiwL State C4. Architect/Designer's E-mail Address Zip Telephone fS/-G$ 311(21 ENGINEER'S NAME Last !�u s yez First A5_ •rJ Lic. No.F! Engineer's Address City (✓ f f v Q State Engineer's E-mail Address mJ*- p✓i ar % CdI o4 Zip . 9Z(ZC). Telephone 9Lq f 3 -3j16 CONTRACTOR'SNAME/COMPANY i�L lY�rl��us Lic. No.g(osg9Z Class Contractor's Address City j�N�Io/�D✓1 _ . State CIT SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's E-mail Address e4�L1^14X,_pmtCzhsI/ae--7o A,cow Zip ?"(_ . Telephone T/(-7 �,57 _ PERMIT NO. x2021 -Z880 PLAN CHECK NO. 25IZ USE ZONE DEVELOPMENT NO 4/ w21 SUS 68 PLAN CHECK FEES $ -Uzi Valuation Material/Cabo Owner's E-mail Address �_3� dal,2m ✓t _ 1713 ..oSz�� bluK-t r? `yGdr-��,cvvv! i City V�/Po r' �ya State [� Zip %ZG S Telephone �/�-S!©- O i j2 /` P 7 APPLICANT'S NAME Last Applicant's Address City 1 m cl State I Z First Applicant's E-mail Address .D�k�r�senl,�u�1 � �/crGe��alo�l Zip �l�S� Telephone ARCHITECT/DESIGNER'S NAME 12 F Last J � c{e�-f' First � �t7 ,.,15 Lic. No. Architect/Designer's Address City t/f/iiwL State C4. Architect/Designer's E-mail Address Zip Telephone fS/-G$ 311(21 ENGINEER'S NAME Last !�u s yez First A5_ •rJ Lic. No.F! Engineer's Address City (✓ f f v Q State Engineer's E-mail Address mJ*- p✓i ar % CdI o4 Zip . 9Z(ZC). Telephone 9Lq f 3 -3j16 CONTRACTOR'SNAME/COMPANY i�L lY�rl��us Lic. No.g(osg9Z Class Contractor's Address City j�N�Io/�D✓1 _ . State CIT SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's E-mail Address e4�L1^14X,_pmtCzhsI/ae--7o A,cow Zip ?"(_ . Telephone T/(-7 �,57 _ PERMIT NO. x2021 -Z880 PLAN CHECK NO. 25IZ USE ZONE DEVELOPMENT NO 4/ w21 SUS 68 PLAN CHECK FEES $ -Uzi