HomeMy WebLinkAboutX2021-1194 - Permit Application (2)i
Print Form Worksheet for Combo Building & Solar Permit Application Saw
Comm'I ResidentialCity of Newport Beach - Building Division X207_(-'�'��}q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
5ZBuilding F_Grading F -Drainage IXEIec rMech XPIum Cu Yd Cut Cu Yd Filll
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F- Landslide rN/A Floor Suite No
F
2419 SANTI EI C^(0 D9,
Description of Work
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Use Const Type
#Stories #Units (if Res02114) )
MO O<4 S INSiRI•L•NEW Poo %,.
LI. 1%05, FT
'Qli'Ir'f012M W/ C-tHVPS2:Wt�$UDt,_.IAISI'Ptly. NGwSNp%pEJT¢UG'fV'R+E o`��
New/Add SF[ Remodel SFF
Garage/New/Add
Valuation $
Material/Labor 7_00%000
OWNER'S NAME Last sKTc.cc.
First �
Owner's Address _JPSIsCOY,
Owner's E-mail Address
2-41°1 5AN'[I QC'Io DR- ..
State C_Pr Zip Telephone-
City NEWPORT_ 6EALN'...
APPLICANT'S NAME Last
First SoWoS,nq
Applicant's Address
Applicant's E-mail Address
2U2� Vic, $olonol
dG��rMr��CYV\UL$�caYYY0.\1•COY�^t
City SGXi. C1CYARJI'1�'e. Statec
Zip cru b, Telephone �z+c)4�i Z -o" -g
ARCHITECT/DESIGNER'S NAME Last
First I Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State r
Zip [_ Telephone
ENGINEER'S NAME Last TINpALL
First GIFOWCIF, Lic. No. Igc1Z)
Engineer's Address
Engineer's E-mail Address
33wS,EMit2FfLOIA6 RAE S'Te 20"1
City I PrN mie1 M State C A „
Z p `12ibb1a Telephone 94-K 222'01IoS
CONTRACTOR'S NAME/COMPANY CA�imC�ga
J
Lic. No.g19b1� Class Ps1C-B
Contractor's Address
Contractor's E-mail Address
110 SP�ReNA
CO\'Irl4.f>iLCaQI M% nO VO. LC, rYl
City 1 aNAKT- State C�
Zip 1 �- Telephone q�}q z3S �ta4Z
SETBACKS REAR SETBACKS FRONT
PERMIT NO. W • Q
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ,
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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