HomeMy WebLinkAboutX2021-0830 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
j- Comm'I '(Residential City of Newport Beach - Building Division lzlk"
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading F"Drainage I- Elec
Address
F Mech r Plum Cuydcutl CUYd FIII
r Flood r Fire I- Liq I-' Landslide
%� Gqr G Li 17-F t> e , v'�, faP'T
of Work
f!�%z= L�,e,.�_, c
FNIA Floor
cILL C-3 �-
-t7E_n
New/Add SF Remodel SFr-- Garage/New/Add [—
OWNER'S NAME Last
f•' .__
Owner's Address
?- 4 C7 4 G am; �- F D ,2
City ,+✓lti� p v AState F_ -A
APPLICANTS NAME Last
/j N O C � Vic, .✓
Suite No
Use F—ConstType r_.—_
# Storiesr— # Units (if IRes)r—
First I A-11 I c-,...r 4 e�"L
Owner's E-mail Address
abort 15,600
Ml6HgEL FEc iX t15! 6r vlA1L-, cy
ZJP '7 Z� G 7j Telephone 7 (4- - 3S 77
First) 6,-,4,,4 -/
Applicant's Address Applicant's E-mail Address
C>C!
7'jLL IJrA �A�JrF1
City p State e, -6- ZIP `1 LS' % Telephone 7 t i `( Zu- ��Z
ARCHITECT/DESIGNER'S NAME
Last T a A e� L\ First L R� i Lic. No.
�—
ArchitecUDesigners Address Architect/Designer's E-mail Address
2Ni� NAp-A X>,�L S 16_i-+ST/�>i
City 5%7 State �— Zip io��I Telephone S�I-4s-
��
1S 2
ENGINEER'S NAME Last
A S T I r_ '_'Q
Engineer's Address
L< j r q 8✓ P-C'aA N rG. (� Cam/ i7 .. �{'�- �.
City �./ '�-a A, A/ _ State �-
First ,' Lic. No. $'�6 Z
Engineer's E-mail Address
F/st-4 er.Ae,(JaS�r
L
Zi ' / 5 Cu
P S� Telephone �I � -i f 7Z
CONTRACTOR'S NAME/COMPANY
5 (7c A r.cy-�,rC Lic. No. Classy $ -
ContractorsAddress Contractor's E-mail Address
AL
62—sv6G,
city C (1> r / State C Zip 5'd..91 St' Telephone se a-_ S 71 _ -1 '7 o G
ISETBACKSREAR
I SETBACKS LEFT
I USE ZONE
SETBACKS FRONT %�(A
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. ���(-)
PLAN CHECK NO.
PLAN CHECK FEES $