HomeMy WebLinkAboutX2021-0804 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I XResidential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F Grading j—Drainage DirElec r" Mech
F_ Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) I_ Flood
F_ Fire r- Liq r Landslide rN/A Floor Suite No
Description of Work
Use , -3 ConstType v-D
INTemm-asm,nw-Tb t`++ i.Mo trw(
r%*^ As "'R&4.- ai
#Stones # Units (if Res)[_
/a 'th./l FV�-'rro(1rNCIL (,o�+VFn.St�.-I wl'('t}
NOOITtsr.!
Valuation $
Material/Labor
(3251'coad. Remodel SF 'L000 � Gara a/New/Add ..
New/Add SF�� r 5 g
4. 51 S F
Z�(�
OWNER'S NAME Last urn
First ,�5a�,
Owners Address
Owners
�
,E-mail /Address
,/I�1
v"�G • vI Gil2l� �t��i�YdlfitS ' �/M'L
2(�G
City ��'E'QC"('1 State C �
�if?
ZipS Telephoned
APPLICANT'S NAME Last C6,(j,(,�6$o
First I H 1"ow,
Applicant's Address
Applicant's E-mail Address
331T RAMt6Nk Drt•
ICAM6S4Consvli'rn'Gc@9Mg11.Coon
City I 5A.-Tk A►NA• State
Zip 41Z767 Telephone '11C(• lu,4ZSp
ARCHITECT/DESIGNER'S NAME Last M"A Lic. No. —
CA2OOS'o First
Architect/Designer's Address
Architect/Designer's E-mail Address
17 R.Ant6wp, P(l.
CavdloSoCohsu141n5ct:e,9wLdLI 4,
City S�t f(A, p,,,h., State I CA,
Zip oI27p7 Telephone 71y. 12( G2So
ENGINEER'S NAME Last I
First F MIGOAIFFI.. Lic. No. CS941S
Engineer's Address
Engineer's E-mail Address
3317 2AMoNh un,
City I SA"T,l At-JA State CA,
Zip 01�707 Telephone7IQ•�21.•GZSO
CONTRACTOR'S NAME/COMPANY Lic. No. roClass) S
GI f'
ctto)r's Address
Contra/
Contractors E-mail Address
on47 O 7)4W�U0614-
C0
VUC! &0- Z'ct IOt / 001e� COM
City /, U�� �,Q State
Zip Telephon 7/Ll)�'�3 •C�'�./�
SETBACKS REAR lis SETBACKS FRONT 7,0 I PERMIT NO. r vl/21 - S oh
SETBACKS LEFT SETBACKS RIGHT 41
PLAN CHECK NO. 07 VS ' wZ(
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
S^