HomeMy WebLinkAboutX2021-0980 - Permit Applicationrnm rorm ( VVorKsneer FOP uomoo tsmiaing & Solar Permit Application //W "`,
j— Comm'I r Residential City of Newport Beach Building Division tl1 "I r (� f iFi
NC1TF' PI AN RNFRi! FFFS ni IF ATTIMC nI OI I.rt rI r I J PPS \ 777
wilding rGrading F -Drainage rElec F_Mech j -'Plum CuvdCut F cuvdFill
Project Address (Not mailing address) F Flood r— Fire r— Liq r" Landslide L -N/A Floor Suite No
F_ F_
i
Description of Work
Use F_ Const Type I
a
# Stories # Units (if Res)s
Valuation $
Material/Labor) ,
New/Add SF— Remodel SFr----- Garage/New/Add !-- —
OWNER'S NAME Last `A/ _,@@ First
Owner's Address ..Owners E-mail Address
g
1!`!S K_ � yr �S� �✓1
City%VC(w �� StateCI !� Zipr Z U()Telephone TI 7� 1 337i�
APPLICANT'S NAME Last First
(� L!/I��
Applicant's Address -Applicant's E-mail Address
!�
3�ZJ l//�� Ac .Yin
AiAc � .. v 7 , 6,1
City AN,�C n , �(I�(. � State F(Z -- Zip � � .� Telephone �S l —1220 Yi< q
AN,
(
ARCHITECT/DESIGNER'S NAME LastS` Firstr — ----
e C3 OffLic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F---- Zip (------ Telephoner-_--
ENGINEER'S NAME LastFKI�� �. /�� First— Lic. No.(Z�
33�
Engineer's Address Engineer's E-mail Address
�hwItc -zoo �LC
city State TelephoneI
Zip
I 1bJ G
CONTRACTOR'S NAME/COMPANY Lic. No. �t Class
�f
Contractor's Address Contractor's E-mail Address
�Iloo \,1W6,e6us+
City I �Jqw State o
q,(. IXQch I .Zip .,ll (U(pd. Telephonel Qq1.��(Y(➢':
SETBACKS REAR SETBACKS FRONT . PERMIT NO. u
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0. ,,>r
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
�u )6 sl 11 X 171