HomeMy WebLinkAboutX2021-1239 - Permit Applicationx2021 1 Z��►
Print Form rkl eet for Combo Building & Solar Permit Application
Comm'I r�Residen ial
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(✓ Building f— Gradi r"
rainage F_ Elec F_ Mech F- Plum Cu Yd Cut Cu Yd Fill l
Project Address (Not mailing address) F Flood [— Fire F- Liq F_ Landslide [_N/A Floor Suite No
Description of Work
Use Const Type
�ti rf a'P urs! d -e c�.
16
wa m CIVIC1 po � p^�,
# Storiesl�yi r # Units (if Res)F
New/Add SF Remodel
luation'$
SF Garage/New/Add - aterial/Lab r
OWNER'S NAME Last
Kriy,t First i
Owner's Address
Owner's E-mail Address
6l� v4v,! Ptack
VakII 941 e olil-Uvn
9elephone
city Yvl. IA'.. laeac _. _ _
_._.. State CA- Zip q_.
y( & 3 FqLAC -LAVA14Z(p
APPLICANT'S NAME Last
1� ��� First PWV--
Applicant's Address
Applicant's E-mail Address
b
City '' '' -�dds �r7�-la�c1P
State Zip g2t063. ..Telephone( u6pl/t
ARCHITECT/DESIGNER'S NAME
Last I'�l �h _ i. FirstTfl ff � Lic. No. —..
Architect/Designer's Address
Architect/Designer's E-mail Address
PFJ,
4-crie eovooe Wive.Cdbil
City I. 3mol Wye( _
State I A _zip g2k_T? Telephoneq�.2g0._7(037
ENGINEER'S NAME Last
ea;5 First f z�T .ss®'. Lic. No. q a�joCI
Engineer's Address
Engineer's E-mail Address
16 ^ S�FYeef
, Se e R 5CO-4 @eSi-wne, eo
City & w A Aw _ _
State A _. _ Zip q j70 ` Telephone -1i1I.A. (}3S 2,eVC
CONTRACTOR'S NAME/COMPANY �t 1/ 11C. &Jll 1jWWti, Lic. No. IU6lvs-Z Class
JJ Fac �C��ontractor's
Contractor's Address
E-mail Address
1b 8oX t7om
kevl'tn� jvKkelle�ivtC. Cowl
City 1 Mt vvkgq _
State Fe A. Zip q 262(0 Telephone q4q .3 S'S, 1109
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $