HomeMy WebLinkAboutX2021-2241 - Permit Application77-1
Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEFS n1 IF AT TIKAP nr cl IRAAI1 A!
r Grading rDrainage �Nlec \F,,Mech Plum Cuvdcutl b Cu Yd Fill
ject Address (Not mailing address) F_ Flood r Fire r' Liq r Landslide rN/A Floor Suite No
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Description of Work
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Use I 'FD ConstType
# Stories # Units (if Ress
2�J-I �•'�T- �DDL-[1o1.Lpt
l� �� to oL�
�Lr"LY'"�� (mil YD CT
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Material/Labor
New/Add SF '" �� Remodel SF � j_, rj Garage/New/Add F
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OWNER'S NAME Last
43'Q r=J �..` First V QW
Owner's Address
Owner's E-mail Address -ph-)
t` bc) PtP
City —+.+�t��:�1\
t
State r� Zip n dro Telephone 621
I `FLiirrsttI VW 1
APPLICANT'S NAME Latest
ij ��L (1 i ' Q�
Applicant's Address
Applicant's E-mail Address
-LIn4
City t-�j -61 X-VI L 11U13
State F Zip Telephoner��C"�
l `il 9 J�ZI' 1-1
ARCHITECT/DESIGNER'S NAME
Last �� g
t-xa 1131--T First 66Tw -5 Lic. NoT—
Architect/Designer's Address
I rr�-t 17
Architect/Designer's E-mail Address
1 -
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CkY t`1 l l
State Zip �� `� Telephone 4
ENGINEER'S NAME Last
v�_ First Lic. NoF47 __ mac.
Engineer's Address
4141111(.`�LIS
Engineer's E-mail Address S°--� 5 (5J✓
M)h 68S
City
State l � Zip q ✓ZJZ.o Telephone - S'j j )- I
CONTRACTOR'S NAME/COMPANY
i -ot-L Lic. No. �,( Tlei Class i�
Contractor's Address
Contractor's E-mail Address
2'I I rl l
City m��/ G,;U 6D
State Imo"'— Zip g21-' 11 Telephone GVi4� SA jq
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N13.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $