HomeMy WebLinkAboutE2021-0285 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit A" "pplict Of
W "
Ir/Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL (0�
rBuilding f— Grading (—Drainage �lec r Mech f— Plum Cu Yd Cut l I -- Cu Yd Fill F_
Oct Address (Not mailing address) F Flood F- Fire F_ Liq r-- Landslide
rN/A Floor
Suite No
Description of Work
_Film Use F Const Type F
xr`5 f lu AST• OmRAO T 1L. `6
1 (7! t JS GO s�T?�j 7-v T #Stories # Units (if Res)
UPS Prnn 9 tZ, aN 71167 3 P -n N t2 jaW ,,
New/Add SFr--' Remodel SFF-- Valuation $
Garage/New/Add F_----' Material/Labor Flo
OWNER'S NAME Last FSWE I xo_^/_ First C
><iiLt S
Owner's Address
Owner's E-mail Address
6S0_ NsWPa1�' Ct��Ti�A,- bR.Jyg_
City As+aP7ao1'..;9 'ACTH State�A� ZiP(& Telephone _.
APPLICANT'S NAME Last— t 5
Applicant's Address
I-57-31 4.46WAIA cr<Wt9X/ RP.
City l RV 1" State
ARCHITECT/DESIGNER'S NAME Last
First 1. N&p,,,
Applicant's E-mail Address
IIJJAEPLiS (J7k ISG. (�prL�
Zipgf /�/ Telephone
First r—_ Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F--- Zip [_ Telephoners-----'
ENGINEER'S NAME Last ISWAKI j
Engineer's Address
I5Z3► I MfUNA cA1j)1px/ iza.
city State F
(A.—.
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
First l7kA)/Mt7,Yb Lic.No. if a
Engineer's E-mail Address
I XS VVA�i ,0 i A) 50. T
Zip gZl—G/� Telephone A 11--5 spsz�
Lic. No. 2, ry Class L+�
State r---- Zip
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
Telephoner—
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $
OCI I tQ .?,U2 (