HomeMy WebLinkAboutX2021-2941 - Permit ApplicationPrint Form W sh t for Combo Building & Solar Permit Application d�`"'°° m
Comm' F Residential City of Newport Beach - Building Division o
NOTE: PLAN CHE FEES DUq AT TIME OF SUBMITTAL
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ProjlIect (Not mailing address) r Flood
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Description of Work 4, �OMll Rai Q
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Use °j 1 ConstType Ulm
# Stories #Units (if Res)
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Material/Labor
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'AWNER'S NA E L Ct'I V\e
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Owner's Address
Owner's E-mail Address
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City ; te.i,)POY-+ , �Q�k State CA
Zip F—TelephoneF
APPLICANT'S NAME Last Richart
First Jason
Applicant's Address
Applicant's E-mail Address
1041 W. 18th St, (At 06)
Jason@richartdesign.net
City Costa Mesa State CA
Zip 92627 Telephone 949-422-9191
ARCHITECT/DESIGNER'S NAME Last Richart
First Jason Lic. No. F
ArchitectlDesigner's Address
Architect/Designer's E-mail Address
1041 W. 18th St, (A106)
Jason@richartdesign.net
City Costa Mesa State CA
Zip 92627 Telephone 949-422-9191
ENGINEER'S NAME Last �J �Y�\iYl @
First Arn ; yl Lic. No. e7O'��
Engineers Address
Engineer's E-mail Address
23172 Q�'1 po in D
City Laau o, i1aUs State C�
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Zip Telephone c\4q_.ArSLA— I AH
CONTRACTOR'S NAME/COMPANY Lic. No. I'-f 9�y-jClassr—
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Contractors Address
Contractors E-mail Address
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City C T4\. 1� Sla State CA
Zip �Zte Z4 Telephone c, cqq) �ly5e ocjo�q
SETBACKS REAR SETBACKS FRONT
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PERMIT NO. )/ - Z- l
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. �S
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $