HomeMy WebLinkAboutX2021-0749 - Permit Application (2)�2021-o�y�
Print Form Worksheet for Combo Building & Solar Permit Application
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F- Comm'I r- Residential City of Newport Beach - Building Division_
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL p0.NP
F_ Building F Grading
F-Drainage F_ Elec j" Mech F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not
mailing address) F_ Flood r Fire F- Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use Const Type
�{ 5E+owE2 i-)CC - LiIc6 {'vfz L►Koe �
# Stories[ # Units (if Res)
/�
VCR �-
Valuation $
New/Add SF�
Remodel SF� Garage/New/Add
Material/Labor
OWNER'S NAME Last First .►C V-1
Owner's Address
Owner's E-mail Address
GW�2CC: 5 12�LI�i �cvl<�Ns iJ
City I 'J e>
State FEA Zip c Z4 6c> Telephone ?- O'.�6( LlS(S
APPLICANT'S NAME
Last -?7Atz1 F First cfQWA E
Applicant's Address
Applicant's E-mail Address
21�3( 54-I1451A C-14te-6
(Z1.> c%AAN4 �6'Cr-iS"t2Lfc: IoN.OS
City LA K6 . � 2 �Si
State �� Zip 9 ZG`2, 6 Telephone C1 1111
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Arch itect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip Telephoner
ENGINEER'S NAME
Last � � First F Lic. No.F_
Engineer's Address
Engineer's E-mail Address lQ
City
State Zip Telephoned' -
3
CONTRACTOR'SNAME/COMPANY S-r r_u e, -C (0 01 10C Lic. No. Class
Contractor's Address
Contractor's E-mail Address
SSE ` A�Kc�lnl'i� Sri
CfFAO<� /O_Z'Z- (fvraSi4-VCT_10f + • i)S
City WMSSi01.3 Vi
State C•_f- Zip Telephone ett-tq , •:�-lZ •qc( 6&
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
1