HomeMy WebLinkAboutX2021-2756 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm'l (" Residential City of Newport Beach - Building Division g
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building j_ Grading r-Drainage >Elec Mech F- Plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood KFIre r Liq Landslide rN/A Floor Suite No
3912 may, F Flol
Description of Work
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Valuation $
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OWNER'S NAME Last M co�\ a ,�i%�.'12;Xz.fkviC,- Py(0�2V3,4 yy*o
Owner's Address E-mail Address M� 51111..)tl
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City State I CA Zip 615 113 Telephone8.. Z',� ..��
APPLICANT'S NAME Last 9--YcZ First `,(c rv, binsior\ I I t A nal .
Applicant's Address Applicant's E-mail Address
31ci6 S. kireotf �olp irene..Ob77Ca%1dLwo.corm
city C�o _ Iw - _ MeState �''A Zip � Telephone ^7r'
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ARCHITECT/DESIGNER'S NAME Last R66nSon First Mr 1��w20r-73I
Architect/Designer's Address Architect/Designer's E-mail Address
31 15 'p.,• Atrp-34� L. .e `)Y. IYob*+tc_pY� O�Y�IGIY�C. ►'1e�
City�.SC4Mesiil State F-(5k- Zip "/ Telephone 71�{- BZ —8g� r '�
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ENGINEER'S NAME Last First F Lic. No.
Engineer's Address Engineer's E-mail Address
City State 7- Zip Y Telephoned
CONTRACTOR'S NAME/COMPANY gA,.�l.a ✓ Lic. No. �G ,Class
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Contractor's Address Contractor's E-mail Address
City [_ State �� Zip �- Telephoner
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. '-7�I '
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $