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HomeMy WebLinkAboutX2021-0900 - Permit Applicationx uzl-/� Print Form Worksheet for Combo Building & Solar Permit Application o4��W�gm r Comm'I r— Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL oa•' (ZBuilding r Grading ('Drainage rI Elec r Mech r— Plum Cu Yd Cut Cu yd Fill F Project Address (Not mailing address) C Flood [ Fire j` Liq r- Landslide FN/A Floor Suite No 42H AAw-u+0, ©riVc Description of Work 1. %JQ W an%ok . r . (Qrh/ 6 €iK%'skr Use SSR CanstType �/� ,,,t_� r - - v + A - #Stories #Units (if Res)' IYe.� to N bed Kitt_ H. Nea Q;-C�� bw OL+ k cam* 8&( Valuation$ Material/labor New/Add SF 16o Remodel SF , 6 Garage/New/Add —�' OWNER'S NAME Last First CTG�F V Owner's Address Owner's E-mail Address Lit_ { ny_ui a Drive-, City I AJe&,)poyt eeAcK State CA ZipF— Telephone _7jH_S2.2,_0(0SS APPLICANT'S NAME Last Richart First Jason Applicant's Address rnb�- Applicant's E-mail Address ll �� 1041 W. 18th St, (Al 06) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. F_ Architect/Designees Address Architect/Designer's E-mail Address 1041 W. 18th St, (A106) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ENGINEER'S NAME Last First I ' � Lic. No. 60 g6-7 Engineer's Address Engineer's E-mail Address X1202 AiLah 'C- &ve- . sL e, City I L.Dho 8eG,.C� State e V Zip 9d 8Z) % Telephone `Z— 6 2-3 85 CONTRACTOR'S NAME/COMPANY Lic. No. [-- Class Contractor's Address Contractor's E-mail Address City State F Zip F Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. � - U ��II 'L !� p� USE ZONE DEVELOPMENT NO r U - ' d PLAN CHECK FEES $ I 12