HomeMy WebLinkAboutX2020-2194 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application ?EWPoR ,
City of Newport Beach - Building Division xZo'�' 21°l� o F
r Comm'I F Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(Building F- Grading F-Drainage FVElec 54ech FC-Aum Cu vd C4 Cu Yd Fill F
Project Address (Not mailing address) F_ Flood F- Fire/Liq F_ Landslide rN/A Floor Suite No
3336 VIA J-1PI /y[JVOas , e/s !A 74G63
Description of Work
Use F_ Const Type R.65
# Stories — #Units (if Res)
Aea- L✓/NDD+,JS 'f2 3G• /r AD+'+Pc.J Zwo r�cdaR
r�
46rr0yac Iff'iyl't.J 74 3Av,AIZ06Aol i
Valuation$
New/Add SF g L Remodel SF 00 Garage/New/Add
y5b 0�j( 00
Material/Labor L i
OWNER'S NAME Last �GD+f First �� N
Owner's Address Owner's E-mail Address
333Cm VIA, Glva KrrG�C/�G �GiyAlL, CbivJ
City /ULalPo;s %l�d.KN _ State ('a Zip ciZl (e(, — Telephone 15/-G Z�1-36/l
APPLICANT'S NAME Last F First
Applicant's Address 5AM¢ -+5 Ow..Jcit f ri'FEMQ87iC'd 1MII(
. State �- �v Zip F Telephone
City F_
ARCHITECT/DESIGNER'S NAME Last rAGy1 First V SHU��� Lic. No. I 2
Architect/Designer's Address Architect/Designer's E-mail Address
//Z E Sv ireF P
City CBCA� J6C State 4'A Zip FVS42 Telephone 1/!(, f97- 9izo
ENGINEER'S NAME Last First Lic. No.�-
Engineer's Address Engineer's E-mail Address
City State F_ Zip I Telephone F_
CONTRACTOR'S NAME/COMPANY Lic. No. �1Class
�fgPfSiZ,a,.� l.G^!15 /uc can Er�ih� a F
to
Contractor's Address Contractor's E-mail Address ,1-U(S i)
City t3R / [_ F State C�— Zip T 2 Telephone (-f -50q - -7�(' f
/
SETBACKS REAR SETBACKS FRONT PERMIT NO. �(��W..-f
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.� ` �•
rr
USE ZONE DEVELOPMENT NC %.l� '®� 1 PLAN CHECK FEES $