HomeMy WebLinkAboutX2021-1239 - Permit Application (2)K202�-1Zb61
Print Form '' Arlo eet for Combo Building & Solar Permit Applica ion
F_ Comm'I �Residen ial til City of Newport Beach - Building Division (I
f(, NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F'Building r Grading Firainage F_ Elec r Mech Plum
Address (Not mailing address) F Flood F7 Fire [— Liq
Cu Yd Cut Cu Yd Fill
F_ Landslide [N/A Floor
6 t 6 _Kchc s _ ?lace,
I
Description of Work
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New/Add SF
OWNER'S NAME
Owner's Address
6l$ V-(Vjs_
City Iv( -I
APPLICANT'S NAME
Last I -)/,V0 V\ -.---_ First
Suite No
Use kj%./, Const Type�L
# Stories # Units (if Res)
Owner's E-mail Address
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State c_j%t- - Zip q� TelephoneA L(C(� q alto pt q 2L
Last V_Vpc%�\ _..- First
Applicant's Address
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City ;jQrti4�f/Fr tri _ State _.-. CA
ARCHITECT/DESIGNER'S NAME Last�I h ��
Architect/Designer's Address
2°523?, &x, o ci
City (.G+9elVt6t (U(at/2( State
IMFCA
ENGINEER'S NAME Last eo:;7
Engineer's Address
1600 E. 16^_ S-h�ee, , sine P
City 1 StyriaAm State (' A
Applicant's E-mail Address
5/ aw/t,
Zip a2r063. Telephoner Gtwoe,
First Tf ffr Lic. No.
Architect/Designer's E-mail Address
R_eirY4 eovwo @ We •Cdvtq
Zip q7,(y i% Telephone 1 LR_- 0.`7Co 37
Firstr�Lic. No. R'S 061
Engineer's E-mail Address
5 co .4 @ e6 i "FVKe , c0 Vh
Zip gj70 (. _ Telephonehtt.f.-o375-.,��
CONTRACTOR'S NAME/COMPANY J t/_tl.� i11_� Lic.No. 561e)'S'2_ Class
Contractor's Address G�[C�ontractor's E-mail Address
lJBax l2U(q �eut'N@ JvxkellzYi�C. Coves
City m6 VYkg6( _ State CA_ ZIP g262(v Telephoneggq.-S q 10
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $