HomeMy WebLinkAboutX2021-0242 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application aW
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j— Comm'I Residential City of Newport Beach - Building Division xLe Lei, , 0 ZLi a
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r- Grading j -Drainage IVElec FMech F> -/Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F- Flood r Fire r Liq r Landslide rN/A Floor Suite No
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2oi52 V/ Lii'fG N_,R Nc%/RDRT 66L
Description of Work
Use F—ConstType F
# Stories FT#Units (if Res)
M n
Valuation $
Material/Labor 2
New/Add SFI Remodel SF & v Garage/New/Add i --
OWNER'S NAME Last I \Xf(J �$ F�� First CA 5C-/)/
Owner's Address Owner's E-mail Ad ss
20152_ kZ iN,F V�, FX00 2 C MI`Z, c.�
City V(jQDFCF} State t yt Zip 526tv0Telephone—Lf�g-�S�%
APPLICANT'S NAME Lasti U m_,> (e c tH First A(J t
Applicant's Addresi=s Applicant's?7 E-mail Address
229& VlA- �`J dZ�I�� �� I�L 06-09N5r"v(-Iisq<5 CDlti\
City R1 JL State I -T ' _ Zip �5 F96 Telephone • /�--7�6-3 (.1
ARCHITECT/DESIGNER'S NAME Last First I Lic. No. �-
Architect/Designer's Address Architect/Designer's E-mail Address
City �- State �— Zip �— Telephone
ENGINEER'S NAME Last �— First F_ Lic. No.F_
Engineer's Add ss Engineer's E-mail Address
City State F Zip I TelephoneF
CONTRACTOR'S NAME/COMPANY V1�J�"" [_c ,5.-rRVC719h1 lZ!^ST0zf, jvoVy Lic. No. �tj1 j S Class
Contractor's Address Contractor's E-mail Address
12z% 6 F_ iA) R'T-t9 H VIA( tit aA-' 2) WON $T -Ru ('71, s V I c5i , C � ✓ A
Cit' A4K,4-4,,AIM State I °'' - Zip /,2?06 Telephone *JLC -W - (*00
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $