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HomeMy WebLinkAboutX2022-0193 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application l lli (- Comm'] r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL _-Building _Grading _Drainage I-Elec F-Mech _Plum Cu Yd cut Cu Yd Filll Project Address (Not mailing address) F7 Flood I- Fire (- Liq I- Landslide I _N/A Floor Suite Ni Description of Work Use F Const Type F L2 tj Storesl�#Units (if Res)r Valuation $ Material/Labor F9 New/Add SF F— Remodel SF IF Garage/New/Add OWNER'S NAME Last WPC) First 1 Owner's Address �" F 0 (7\ Owner's E-mail Address 10 �pj XPi L� SI City �� State C/Fc Zip `,� b�3 TalephoneE4�1�S APPLICANTS NAME Last 15 M 1� First Applicants Address Cfa( Applicant's E-mail Address A',v�ussmt-r14 4Gbw City S�� ' Aw � _ _ State •/\ T Zip 9 7 a��-- T—eleph—one `�j—(t�� ARCHITECT/DESIGNER'S NAME Last'l First Lic. No. �— ArchitectlDesigner's Address Architect(Designer's E-mail Address .. .. - _. ._._ __ ..._ City State �— — -- Zip ! Telephone ENGINEER'S NAME Last i x I R V First I Q I(A Iv CLic. No.r Engineer's Address I o (��VZOOQ-14O�1 OW ES Engineer's E-mail Address d City �(} �t✓{% State Zip 1�`J ().S Telephone['. 14 6 �,� S I D CONTRACTOR'S374 (( b Class Z NAMEICOMPANY CC Lic. No. N Cyt�S Jf/1 I. 4'-F L/ O "S6 Contractor's Address- 1 �� 4 CI�Nwotu �� lC --- Contractor's E-mail Address ���ssPA iTI4 GUx . N City ( (�_ GN Qa State G Zip �% Q Telephone, 14 SETBACKS REAR SETBACKS FRONT PERMIT NO. X W72. otgy SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 105.202-2 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ _ -