HomeMy WebLinkAboutX2021-1859 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I Y Residential City of Newport Beach - Building Division oG.�oa
NOTF- PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F -Drainage F_ Elec F_ Mech r Plum cuvdcut F Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire Liq F_ Landslide r_N/A Floor Suite No
600 <;;—, � -TA MCS - PLAC -
Description of Work
Use F—ConstType F_
# Stories[ # Units (if Res)
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ANS �, N p;_?Rpt.,, �v1g To a
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Valuation$
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New/Add SFF—.--, Remodel SF 1 Garage/New/Add --'
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Material/Labor
OWNER'S NAME Last S-1 Zo L -Lo First
Owner's Address Owner's E-mail Address
S -rTAy'I, s
96/,619 State F E _®— Zip %2,46 3Telephoner. —�
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APPLICANT'S NAME Last �' ��. First %4!5S -0_ �
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Applicant's Address Applicant's E-mail Address t
5375 GAQZ'ANc6 (ZV,JY
State Cly Zip Qct 10, Telephone(�Lf_q, 4_,aZ..:-783E
city 17f2v L N ,�5
ARCHITECT/DESIGNER'S NAME Last 1 S LC- J FirstN A 5 Lic No. F-.--'
Architect/Designer's Address Architect/Designer's E-mail Address
'5'AA5 APPL'I cjq `:
City State F_—Zip F_, Telephonef-----'..
V h ic.No.r----
ENGINEER'S NAME LastAL/-/ FirstF.
E-mail Address
Engineer's Address Engineer's
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City State F_— Zip F -a----. Telephone --s.,
CONTRACTOR'S NAME/COMPANY /t/JA6 [J(, f(//` C �iYC" LicNo. �,IU�Y Class
P JContractor's
Contractor's Address E-mail Address
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City WSs'� ✓I/�. State I( _--.. Zip % 6�7Telephone7U_'�;.�) �(
SET A CKSR AR `Vf SETBACKS FRONT 2�s PERMIT NO. 26 ���� "J- l
SET Fq{11C,KS LE T !.� ' SETBACKS RIGHT PLAN CHECK NO.
U ZOI DEVELOPMENT NO PLAN CHECK FEES $