HomeMy WebLinkAboutX2021-1357 - Permit ApplicationPrint Form I Wo et for Combo Building & Solar Permit Application
Comm'I r Residential City of Newport Beach - Building Division tioro t _ iS57 °
NOTE: FILAN CHECK FEES DUE AT TIME OF SUBMITTAL x
XBuilding Grading
mage- lec E p[,Mech r, Plum cuvdcuc�' cuvdFiu,
Project Address (Not mailing address) F Flood r Fire F_ Liq FLandslide F_N/A Floor Suite No
boo ST. IWdKEW S ROAD
11
De�sccriiption of Work
,ii�bF
1
Use const4l
r•pe
wuk&iMLMT of
-i ) t4yr O'P QAtx4 64 %Q(- G(rvl T S
# Stori I # Units (if Res)[—
es)Valuation$
Valuation $
5000
Material/Labor 3 r
New/Add SF�, Remodel SF ',
Garage/New/AddF_
OWNER'S NAME Last
SZON�
First R -W,1 r [-
Owner's Address
Owner's E-mail Address
bOD S' -r. A.r 464 S _R-040
tZi4u� EL S c Sfax tt FrS. de 6
City NGWiliOlf-T �,-4c*
State CA Zip ,jj,&&S Telephone @C(4q 5`7q_-2QuS
APPLICANT'S NAME Last
7-14 YS
First 01494 S'
Applicant's Address
Applicant's E-mail Address
C(1pn1wEGL
_F(__4
INYSC' FMCoe-AiF
City I I -✓Irk
State
Zip R ( j e '', Telephon ,f q l
ARCHITECT/DESIGNER'S NAME
Last
First Lic. No.
Architect/Designer's Address
ArchitecVDesigner's E-mail Address
City
State
Zip F— Telephone
ENGINEER'S NAME Last
AlLmOulyT
First Lic. No. 53 s3
Engineer's Address
Engineer's E-mail Address
)4400 4uAlit, ST- St4t-rF
City I NFWGO ¢ -(' B Fj"
State CA
Zip f tC" Telephone CKg)
CONTRACTOR'S NAME/COMPANY
EMCaRiwPs'A
ENE126Y 9YSz64p I Lic. No.& 6/ Z_/j_ Class/, C?o
Contractor's Address
Contractor's E-mail Address
City 12VINF
State F
Zip �Zfi( f'j Telephone (jc(Q ) f T
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
c