HomeMy WebLinkAboutX2021-3117 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application 0964W
F Comm'I F_Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF
SUBMITTAL
F-Building (-Grading f-Drainage r-Elec Mech F'Plum CuvdCut s CuvdFill
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Project Address (Not mailing address) F Flood r Fire f Liq j- Landslide f N/A Floor Suite No
i 15 E f}Y
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Description of Work
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Use F ConstType
acMo4lrran/
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# Storiess # Units 'f-Res
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New/Add SFRemodelSFs—
Valuation $
Garage/New/Add a/New/Add 1
g Material/La
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City �— State F _ -
Zip F77— Telephone �—
APPLICANT'S NAME Last I
/VbVELL
First
Applicant's Address
_. .
Applicant's E-mail Address
15 Co�C Po RA! _ PL�}Z�9 Sur_ E rSv
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cnt .lferro.+c usfo„�l.o.� cS.
City w�k.PQQT t4C/f�N State �—
Ce,a
Zip 17�G0__ Telephone `lcjLj 723
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ARCHITECT/DESIGNER'S NAME Last
8-� �f wQoR/ First C(f.lL1 S Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
gRANpO.0 AQLHrTEC�•
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Clif.• s br�..alon area.. ��
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City Co57 nq�Ci} State—
— s
Zip 9�GZG Telephone'ilt( 754-'tog0
ENGINEER'S NAME Last t5 -
.� Fkt t
First Lic. No.�—
Engineer's Address
r�0
Engineer's E-mail Address
lGr" rrKEEi __
rhtic�-,_+ta�16 r
City SAi� ANR State CI A
,� • mow,
Zip Q21 701 TelephoneF7M
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CONTRACTOR'S NAMECOMPANY LUSlat\EMMfLic No. 7 ClassF
Contractor's Address
Contractor's E-mail Address
15 CoRPoh�z� et.ltzA 50ri6 JTP
City I State F__
,petZ.sO,.t C Jl�br••. r.ow� eS .G o,
Zip Telephone®
SETBACKS REAR SETBACKS FRONT
PERMIT NO. 1 - 3 t 1j
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N0.
USE ZONE DEVELOPMENT N4
CHECK FEES $