HomeMy WebLinkAboutX2021-2650 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application °4 EWa°R>
City of Newport Beach - Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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(-'Building F Grading F-Drainage F_ Elec F- Mech
F_ Plum CuYdCut F CuYdFill
Project Address (Not mailing address) F_ Flood
F Fire F Liq F_ Landslide F_N/A Floor Suite No
3) F Al v*rr,4Po
Description of Work
Use FRET Const Type WIS711y
r+01lTI O/y ���
# Stories # Units (if Res)s
Valuation $
Material/Labor) 1
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New/AddSFs — Remodel SFF —` Garage/New/Adds—
OWNER'S NAME Last FE! P/ /v/V
First I TOA/0.v.,
Owner's Address
Owner's E-mail Address
3?5- R k,+9iPPo
jPtldman,akorh¢r.corn
City /VEw PORE Uget04 State 09
Zip of f6? Telephone 8/8 4127-017
APPLICANT'S NAME Last VY.IeLLi First - -o y y
Applicant's Address
Applicant's Address
/5* COnPORa.T-e PZ4Z�? /SO
^^E-mail
TDNy d P��eRSd/VC//sTOMHBMEi.CpM
City /v�vv pa7rr rf�,fC N State c� 4
Zip g266o Telephone o y9 YZ 3 - S7a 7
ARCHITECT/DESIGNER'S NAME Last S/vtl77/
First tRAQ FOR p Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
y-0Z(�' 30Ty ST d�eZ
ej: b/'aciSM+/Ti,ANCiY/�'tC fit7 �JM•J/2 • CpM
City NF_WPORT 6e*e.AI State �'.p
Zip gZC6 j Telephone9yq 63/" 3682
ENGINEER'S NAME Last (cam-� G Ho KL 1
First RA ' EZ7 Lic. No.�
Engineer's Address
Engineer's E-mail Address
kE�
,Z6oya /}CeRO/oo
e�
City /yirii/pN WEzrO State CA
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Zip g269/ Telephone qyq 855' zfoo
CONTRACTOR'S NAME/COMPANY �J���rSO%A CGil'a l,n HO /'h Pr Lic. No. 3OO211 7 Class
Contractor's Address _
— -
Contractor's E-mail Address
! S cat'?1201r471 PZ ezf /Sb
ro/✓y D P.orrensaN c6,50..-NP1%OS
City State G/%
Zip A1666 Telephonegy% 72;'/5 a0
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
�—�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 2ca 9ED
USE ZONE DEVELOPMENT NO
✓ -` PLAN CHECK FEES $