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HomeMy WebLinkAboutX2022-0533 - Permit ApplicationLt,"rorm ;'`, `I Worksheet for Combo Building $ Solar Permit Application r; Comm'I L{_!�Residential City of Newport Beach -Building Division Un . OS33 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building F-1 Grading rDrainage r Elec Address rMech rPlum cuvdcutC cuvdFill Flood ❑ Fire r Liq n Landslide Description of Work e New/Add SFF—_777777] Remodel SFCI Garage/New/Add OWNER'S NAME Last Owner's Address 14 3-G-N-e—taar__t-e r City We_.wa� State First rN/A Floor Suite No j L J Use Const Type # Stories # Units (if Res)C Valuation Material/Labor r Owner's E-mail Address 1� i�g_Lloj9.V-_�._1�--@..Y�le-ate is2✓'�----------------� Zip APPLICANT'S NAME Last First Applicant's Address City ---I State Applicant's E-mail Address _2iS iavidSc gp�_ _ 1 o Cest^'1_.- - - -- -1 Zip Telephone �(,_( Z- 919W ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designees Address Architect/Designer's E-mail Address I City State I Zip Telephoned ENGINEER'S NAME LastFirst Lic. No. '7 - - -- Engineer's Address City [C P 110 p p..__._ -- State Engineer's E-mail Address Zip d 2$0_2 I Telephone c/c _y1Zf_'179I CONTRACTOR'SNAME/COMPANY ; - Lic. No. 1021072_ Class �s37 Contractor's Address - if'✓- City�lV�C11I = _ State SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's E-mail Address Zip —j3 j Telephone32� x -4-0-4L - 0 33 PERMIT NO. n4At_7n�- PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ I -0310