HomeMy WebLinkAboutX2021-1292 - Permit ApplicationPrint Form Worksheet for Combo Building &r Solar Permit HpplicaLwr, �'}oo-°
r Comm'IResidential City of Newport Beach - Building Division s
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
KBuilding i' Grading F-Drainage I_Elec F�Mech [YPlum Cu vd CutC) Cu Yd Fill
Project Address (Not mailing address) F_ Flood Fite Landslide f N/A. Floor Suite No
Description of Work be .ee S-h-a 3&1Lj si7 c,�1J -- Use F�_H, ConstType F\Jj(�jj
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of l)A# Stories # Units (if Res)r
�(Q I �-�1 c oyu� 661 ft+I� sq iorclti l �
Val uation$ I DOU
New/Add SF `�Z-Q7 �in ReodelSF�- Garage/New/Add -jqg /' Material/Labor /"[M /
OWNER'S NAME Last
-Po IDS First-1 �T-�, � �cZ1ST I e
Owner's Address Owner's E-mail Address
02 t rYVL i -0- �
City New ar fiei _ f . State Zip �� Telephone ggq__jS-j --]+3
APPLICANT'S NAME T Last U✓�-c-A---mp,-, First���
Applicant's Address Applicant's E-mail Address
227 °I t'M le, In -%x 1Z-4zl F_ nel le hea�s��r�� � label.
City 70VUx- State a.A,- Zip Telephone R—oa-
ARCHITECT/DESIGNER'S NAME Last 1 o b 1 e sY), First eRVA C k Lic. No. ��jS_ 7
Architect/Designees Address I Architect/Designers E-mail Address
f q 65-� W, ifs
City YD Na,- State F�� Zip g2M2 Telephone R0q-%J 7- MO&
ENGINEER'S NAME Last arex_(v� First�dk�b Lic. No.,5 1-4-77
Engineer's Address Engineer's E-mail Address
I g7 fo " M sEe. 1�f_
City A rb yam, State FD,� ZipF $� Telephone P�k-l-�ff-IZIS
CONTRACTOR'S NAME/COMPANY J Li,. No. 1 13 6$1 C_)assF0_
Contractor's Address Contractor's E-mail Address
/4/16 /Z W.a CU6 l 0v(4aJ LµC & vvta,r t
City �_ State Zip -J Telephone (� o-7633
SETBACKS REAR SETBACKS FRONT _ PERMIT NO. XZD 7j` - 1 zq''z
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
M
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