HomeMy WebLinkAboutX2021-2519 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application
j Comm'I Vresidential City of Newport Beach - Building Division x2o —�i n
NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Grading f -",Drainage [-,Elec FMech X* Plum Cu YdCut F Cu YdR117
Address
in
(Not mailing address) F_ Flood f—, Fire F_ Liq rj Landslide rN/A Floor
Suite No
Description of Work A Wl (TbM YPo
Use � Const Type 1
NCW L-A CANTINA 31�FDLD tCDI'L QliTto
S1�kC1k �� w Z C9 x # Stories #Units (if Res)F
�t12(��I.�G� 1'b ,
g Valuation $
Fn New/AddSF� RemodelSFF Gara a/New/Add Material/LaborC�
r
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
SAL �
City V�POIRI '�L'1 ..State r � I _ �J WOL_ r E� Win/ , �.�W
,( p U
ZIP `r Z(; 1 Telephone l Li f ` 2;-5- ZjZ3
APPLICANT'S NAME
Last PENMAW-First
Applicant's Address
Applicant'sI E-mail Address
���L
7^� _r_+\
�m
_� L __ _
y/ LiI�✓�-G�Y1
�hfJ.r� i%��°�lA�
y��P""t,-5tk
city 1\N5`1 C
State I CA—
Zip �2 L( Telephone G
ARCHITECT/DESIGNER'S NAME Last
First Lic. No. F
ArchitecttDesigner's Address
Architect/Designer's E-mail Address
City
State F
Zip F Telephonel—
ENGINEER'S NAME
Last r(� PES
First j Le Lic. No. e '3r(y '7
rr
Engineer's Address
Engineer's E-mail Address
C$ 6_ pp iq 5 -
STE 5 _
50, E5) FV�tt c oM
City Sync -r ftQk
State tf �
Zipq'iT o ( Telephone 71T 935-Z1900
CONTRACTOR'S NAME/COMPANY /((,1
1
Cb)\Jtt(,fl 6�) Lic: No. FV25^03 (Z Class F
('
Contractor's Address
Contractor's E-mail Address
0,v c (�
City
State C�
Zip 2 L (J Telephonefi
I
SETBACKS REAR
SETBACKS FRONT
PERMIT • IA �� am
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. � o' U
USE ZONE
�I U
� 70 ISI O l� I PLAN CHECK FEES $ 11 1 A5.4t�;
DEVELOPMENT NO V7011-