HomeMy WebLinkAboutX2021-2986 - Permit ApplicationI Print Form WO
r Comm'I r< Residential
(Building r" Grading
Address
20 ColomcUl
of Work
e t for Combo Building & Solar Permit Application
1, City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r-Drainage 5<Elec r Mech Plum Cu Yd
I I— Flood r- Fire r— Liq r- Landslide
New/Add SFF — Remodel SFF—
OWNER'S NAME
Last � e�—
Owner's Address
2-0 G u t u'n , w D r; Ve_
City INnW\J(a- Y0, (uc.h State T—
APPLICANT'S NAME
Last
Applicant's Address
City FUG des_ State CA
iue5IGNER'S NAME
Last T—
Architect/Designer's Address
I C S h `v- SJ des- Ave
City C�jTU "-esu� State 6 A
ENGINEER'S NAME Last
Engineer's Address
City
State �—
Cu Yd Fill
j—N/A Floor
Suite No
/%-VCR I+s Use
Const Type F
�� N 4 () 'PVC
fAl6h 'tQ ?dn # Storiess # Units (if Res)[
Garage/New/Add F— 11 �ru rial/ I � ) ,
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First
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Owner's E-mail Address
Zip qI ,/_ n
First
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Applicant's E-mail Address
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Zip (I Z�2 Telephone �,IK Z, 5$
First F\ —
Lic. No. iuol0gb
Architect/Designer's E-mail Address
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Zip Telephone gs�
First— Lic. No>
Engineer's E-mail Address
Zip F�- Telephones —
CONTRACTOR'S NAME/COMPANY
Lic. No. d I Class
Contractor's Address �t� li l
1 Contractor's E-mail Address
city ^ `1i1V1—f?(r��(jor, C�V1r`
�SU State r /n Zip �ZC� Telephone
I SETBACKS REAR
I SETBACKS LEFT
I USE ZONE
SETBACKS FRONT
PERMIT NO.
SETBACKS RIGHT
LAN CHECK NO. ,
DEVELOPMENT NO�LAN CHECK FEES $