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HomeMy WebLinkAboutX2021-1861 - Permit Applicationa X 2a `2- I - aG�, Print Form Wor eet for Combo Building & Solar Permit Application r Comm'I r Residential ✓ City of Newport Beach -Building Division NOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding r- Grading Cu 'roject Address Not mailingAddress) F_ Flood :Fir escription of Work -NP IPJ Yt-,OJT-- fl-a:-M3t5Ei fZEGc�v�YG f vJ�N Cu Yd Fill Pslide r -N/A Floor I AXI f W'fN(?Jqjv� (2cmzrOELY f<17C( f� P/h7 New/Add SFI c _ --- Remodel SFF _o �FeG I �: /'r Garage/New/Add I-� OWNER'S NAME Last First Owner's Address City r/dd tiJ/� j<✓f�%P ((� State Suite No Use F0 -)—QnstType —V / # Stories # Units (if Res)r Z .abort 'LD) C_05:�- 'rZcL2 � JANE Owner's E-mail Address Zlp 9266 Telephone._.s'j,p_r�jr7 APPLICANT'S NAME LastL V-E)2First Applicant's Address r Applicant'sE-mail Address City N . 'F State Zip F Telephone iYb p y�9-¢a gs' ARCHITECT/DESIGNER'S NAME Last ldJ/� LKr— First �✓�iyRll Lic No. Architect/Designer's Address Architect/Designers- e — E-mail Address City State F— Zip Ir---- Telephoner--- ENGINEER'S NAME Last �(2c�fhr?6 First Lic. No.y Engineer's Address X41 _ _ ,�l�r� City CONTRACTOR'S NAME/COMPANY Contractor's Address city State-- Engineer's E-mail Address I�cQn� ��r�ra-n✓ c f�c�L - r�1 Zip 833'33 Telephone g4g,cjOf�^©�'r'r,� Lic. No. —)-301 Class F_ Contractor's E-mail Address ZiP.[---- Telephoned --- SETBACKS REAR) .SETBACKS FRONT SETBACKS LEFT `,3 SETBACKS RIGHT 3� USE ZONE P ^ Z DEVELOPMENT NO PERMIT NO. PLAN CHECK N0. PLAN CHECK FEES $