HomeMy WebLinkAboutX2020-1972 - Permit Application?rinkl T"".: Worksheet for Combo Building &Solar Permit Application �HwWa°am
xuu - �Vr�11 Z City of Newport Beach - Building Div' ' )
9 Comm'I CZ Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SfJ131PAOA1A . _
CkBuilding r Grading `"Drainage JXEIec (7 Me �'�( Plurn Cu Yd Cut uka n on i v
Project Address (trot mailing address) F ood r" Fire i iq r'. LandA& i_N/A Floor / V W®
2714 W ME�,F �,rN"Fb=- CA, 9 443 _
a r
Description of Work
- --
Use j_3 ( Const Type
'
ADDlNG'PdzEl4s JsTFI.aORGu�STDA'>�Ir'rND
,
#Stories 9Units (if Res)F—
.zNDFmVZ6v4Mr0", F4mocwL-SA".gAJ CA6ra4s7�%,coviv7E7z.y
^!4oFwpa9 . A4Lt.,,uc.M A/& 7ogE MIG+1 &-Mc4c.`(, _
Valuatior. $
------�----�-
New/Add SFF Remodel SF[ 105 -sr- Garage/New/Add F _
material/labor
OWNER'S NAME Last First MLC.<
Owner's Address Owner's E-mail Address
Z714 W
City NEW09-T- LA State �A
�� �_ �_� - Zip[gZ663 Telephone g4q_ �Iz -8304-
APPLICANT'S NAME Last �E{ ,/N(,E-r First QIL.L-!A-',�A
Applicant's Address Applicant's E-mail Address
-F
3 17 Z3 U E5 f c w r 7 e (jDELL//�Jf -T� ]ZpD(Nl$CA,0Cr. NE"'%_
City NG' hl 402f Be* C: j Stat, Zip I Z6 rtri O Telephone %49 - 44 2� - 14/2 7
ARCHITECT/DESIGNER'S NAME a
Last /v�$,fE%%�i � Firs[ Lic.No.�—'
Architect/Designer's Address Architect/Designer's E-mail Address
1723.WE37-c1-11PC D� - _ IDNm�;Se-iT-ACDODMScA+°e3.AJ6_r �
City I NEWPD121- - 13CIO'a.-1 Sty to CA Z'P I I Z 4 L O Telephonef 4 1 44.8 " 1 /� Z7
ENGINEER'S NAMEOrr
Last First Lic. No.l 7
7
Engineer's Address Engineer's E-mail Address
City S+.a s F _ o- Zip; Yelephone� —
CONTRACTOR'SNAME(COMPANY ��O�SCAP�rj NG Lic No. 711(oii ,Class 6
15•
Contractor's Address Ccntracior's E-mail Address
1 17'23 _ l JE3TCLl Frr DP, �P9LL_Aj6ex(0j2oD uscAAE3. svcT
city ppjZT 13 c/.(— ICA Zip i Telephone %ipZ
_ 19266® y41 -448 - 7
B SETBACKS REAR SETBACKS FRONT PERMIT NO.
—�
SETBACKS LEFT SETBACKS RICHTyy�� PIAN CHECK NO. W
USE ZONE DEVELOPMENT iV�,.V wo PLAN CHECK FEES $