HomeMy WebLinkAboutX2022-1694 - Permit ApplicationCptCt (2' � 4� G` 0(6Lk a�'T
Print Form Worksl for mbo Building & Solar Permit Application
F Comm'I A Residential e - City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(Building (Grading (Drainage j-Elec (-Meth (-Plum Cu vd Cut Cu Yd Fill
Address
nob Arc-Aa 9'
Description of Work
QI LF (MLIW'
OWNER'S NAME Last
address) r- Flood r Fire r Liq j— Landslide rN/A Floor
+'4 &LLh , CA 12bu D �—
re-I�� in I
Garage/New/Add
Suite No
Use ConstTypeF_
# StoriesF_ # Units (if Res)[—
abojr)f53 Goo
First I Korw) `4 KMhc r (n e_.
Owner's Address Owner's E-mail Address
22D(P N61 t a �+ I K&-the r ( rie ilia � D� Rw i L (_o M
City o—coporT Rich State FN_ Zip q—za-,L Telephone qeP[— cgo5
APPLICANT'S NAME Last I I') Act
First I Jbin ttCX
Applicant's Address Applicant's E-mail Address
31gr/ Alrw,A Ave. <ie: DI `jei�n' bLttl�4wi}hUnt �. fY1
City F5 e-/,A State FE� Zip Gam() Telephone cl:w_
ARCHITECT/DESIGNER'S NAME n
Last �Umsc y), [ First �ti i Lic. No. I
Architect/Designer's Address Architect/Designer's E-mail Address
2852� Klondike, Dr. St-AmZmi6b5t ne+
City �,D&thM VolnLh State I CA Zip Q Telephone (-yJ87_2107(p
ENGINEER'S NAME Last 1b-_ ihm i First I Ain(r Lic. No.l C-CIg tq4
Engineer's Address Engineer's E-mail Address
2e� n 2 plaza Fbi4 Dr,, Sde. 145 Am'r�) Core*b,(_ U re , w(n
City �u na Nll(� State I t �t Zip ol2(nri3 Telephone F1 Ct 54 __72Z(z
CONTRACTOR'S NAME/COMPANY �'t11+ ��lrTtGiL-tLlslII1C. Lic. No. G44(006> Class
Contractor's Address Contractor's E-mail Address
Airwa AVe;c'D1 _jenny I�utldWrlhUni kd.com
City �QS�U mt4bj State eA Zip I %I TelephoneC1oCr
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
s
DEVELOPMENT NO�
USE ZONE
PLAN CHECK
PLAN CHECK FEES $