HomeMy WebLinkAboutX2021-3137 - Permit Application`:Pn�ti Form , 'Worksheet for Combo Huilding &Solar Permit Application
F-1 Comm'I Residential City of Newport Beach - Building Division02'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI A t�
I/ypuilding ❑Grading [713rainage ❑ Elec ri Mech r plumCu rd cut cwd en �/
�\
Project Address (Not mailing address) C Flood [I Fire [-; Liq (-, Landslide R, /A Floor Suite No
�2 c W C3c N ri2ah`7, Ni3, cam. 0 -z ( F �:— F_
of Work
TA.(� 44 ( 5,F
New/Add SF�� Remodel SF � Garage/New/Add
OWNER'S NAME Last
Owner's Address
First
Owner's E-mail Address
Use 'p3JUj Const Type
# Stories[7 # Units (if Res)[
Valuation $
Material/Labor
-52o 0- !' Lrn �P� . Vfc;.zzi SV CCS B C�cVIA,
-- -
City % Lf� 1�1/ �� State, ZIP 1 � 0 ( Telephone R 1 33 7'-12-78
APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
i of-�- tZt 6 (-1i=C Dig . (�� u,ti ay -Ai fec-fU- c.rw�_ -
City a t - StateF-77Zip 2 �G c Telephone C t [��t z_� J L
ARCHITECT/DESIGNER'S NAME Last (/U) C— First ` __fL A- ;
Lic. No. C 2
Architect/Designer's Address Architect/Designees E-mail Address
-
city State �— Zip �— Telephoned=
ENGINEER'S NAME Last j)/(� SC`H� First Lic. No. T3US46
Engineers Address Engineer's E-mail Address
City [, (QX State Zi 2- O Tele hone �7 y
1 �V l - �1�__ P_-� I P C' �C�) d 3 - 7-a7 I
CONTRACTOR'S NAME/COMPANY Dr�eawi n Lic. No. � 4 Ct
}I wre �on4irµ c%cvl �{ 1 Class
Contractors Address Contractors E-mail Address
6323, L;v,A A
City Fdrsr0'e 619 State Zip 11730 Telephone 626-672--n
SETBACKS REAR SETBACKS FRONT PERMIT NO. / (7 —5137
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN; CHECK FEES $