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HomeMy WebLinkAboutX2022-0020 - Permit ApplicationOri 9 Xuatv?, vEWPo� Print Form Worksheet for Combo Building & Solar Permit Applicat on [ Comm'I [ Residential City of Newport Beach - Building Division o NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL wilding rGrading [Drainage [Elec [Mech r - Plum CuvdCut CuvdFill F Project Address (Not mailing address) [ Flood [ Fire [ iq [ Landslide [N/A Floor Suite No 280a RRA'SHVREI N g ICA 4ja(4(08 on in 44 F Description of Work( SES �iG OF RWLV:2$'t-i, J61N Use I—ConstType F_ #Stories #Units (if Res)r— N 1 ERIOR �t``GG--IiAt R4 iZ a% wlNUWIS , J SL,R O � wo sTRvcT, - Valuation $ New/AddSFF.- Remodel SFF14ZO Garage/New/AddF_ Material/Labor 160,000 OWNER'S NAME Last PR� 5 1 First RL L_`0510,1 Owner's Address Owner's E-mail Address 11�`�_�I �-1� Ln ------ (�� zit �_qoL cry City I -W" �t'. _ P State f C -A -'... Zip ,��,, Telephone t q_8%icnz j APPLICANT'S NAME Last e� C7Z First NiJ(ztW Applicant's Address Applicant's E-mail Address 2855 _L' RaT coals H WY. tf Z-34 GoEi'z.A Rc H (!� EflRT44 L INK i NG 7' City Q . j�.. _ .. State Zip .. Z ro Telephone -(4%3- j J 6?. ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State F-- Zip F_ Telephone[— ENGINEER'S NAME Last ADL:TZ, First r Lic. No.F_ Engineer's Address Engineer's E-mail Address City State F Zip �s TelephoneF CONTRACTOR'S NAME/COMPANY ` r JJ I Lic. No. r Class Contractor's Address Contractor's E-mail Address City State F_ Zip Telephone.----_—. SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 013 e Vu USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ S1 MPLt Rl -mg No STI"--�0eivp�� o /61,LL CITY (ejC�rC5 ON PL�� ANi)PE �f-i:LL_ I4'9 -C IF Qut:-Z-" lc5N5 -