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HomeMy WebLinkAboutX2021-1956 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application °Rr a � Comm'I Residential City of Newport Beach - Building Division 4 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALa�' F-Building I— Grading F-Drainage r Elec r-Mech r Plum Cu vd Cut Cu Yd Fill Project Address (Not mailing address) r` Flood r- Fire F_ Liq r- Landslide F_N/A Floor Suite No Ay95 7cCA-v FaLoI, I I -- Description of Work Use 2� Const Type I "' b6AA0 -rTroH #Stories f- #Units (if Res)�I 11.. / U l✓�/ DD 'l Valuation 5 New/Add SFF_- Remodel SFF—Garage/New/Add F- Material/Labor Po/ 0 OWNER'S NAME Last S }.� Lr E H y First t AA-) r 5 ON t Owner's Address Owner's E-mail Address ` 2�}9 S oCIA v SLV � Z� bs �tee25 City State �C,/� f..-co-. Zip �(�.�- Telephone----- APPLICANT'S NAME Last t�DO% First j tXA Applicant's Address Applicant's E-mail Address is Gnk.PoR-s}TE �Ll�Zf1 Sul) E' ZSo �-;-�,.�Pti}}e�-svnG�,s1o�.,.ha�hes. �o,,.� City I n/j;�,lQOR i BC./J-G (-I State �C,9- Zip �?f, Telephone q(+, KO-Z l(,-3:s ARCHITECT/DESIGNER'S NAME Last 6QIU pOA-) FirstFe, f+ PP<) Lic. No. j Architect/Designer's Address Architect/Designer's E-mail Address F1 11 kIILMt ,l 1bR-IV6' Ghfl$ fi✓�on�rcl.%ec(5.C6wt City S TA��„tbid} State e Zip �,�ZI Telephone) '!Zf. -7$'i, O q U ENGINEER'S NAME Last I t5l / F m c First _ Lic. No.r Engineer's Address Engineer's E-mail Address �t tgol, G(o SrKrer �a�l, a(.+�Iansl�eccQ:�eSifwg,co,r City t,eNTA %}/U State f F4— Zip G{-)e, I Telephone 7)y oo 3S. jgOd CONTRACTOR'S NAME/COMPANY BarrERsdN WS%OM f}onClas E$ Lic. No.Fs Contractor's Address Contractor's E-mail Address 15 coeeoQare P',�Iqaq pa rb.,cLss ,C>/" C City N6a/QpQT $Efioi State C� Zip (:_JO Telephone gC(0. 1a3 t'god SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO VZ-O ) ©y PLAN CHECK FEES $