HomeMy WebLinkAboutXR2022-2642 - Permit ApplicationWorksheet for Combo Building R Solar Permit Application
r" Comm'I r Residential City of Newport Beach • Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F-Building F- Grading r•Drainage F—Elec F Mach
r--
r-Plum Cu Yd Cuti Cu Yd Fill
Project Address (Not mailing address) F Flood
F_ Fire r Liq. j Landslide II N/A Floor Suite No
Description of Work
Use �— Const Type F_
# Stories � #Units (if Res)
v�
Valuation a
Material/Labor J c�Ll
New/AddSFF— Remodel SF Garage/New/Add
OWNER'S NAME Last I„
First I TI 2- 11A OR
Owner's Address
Owner's E-mail Address
S` O LL) 11q S�
City _ State �I '�"`
rip GG�� Telephone) `fi
APPLICANTS NAME Last S(11 —Ni-- First R N(iEius.
Applicants Address
Applicants E-mail Address
j 3 42 C(4N Hb N iI,-.R
I �rM i l� 0 •
City State
Zip 1 1 f)�Q 5 Telephone, 94VI14
ARCHITECTlDESIGNER'S NAME Last
First Lic. No. �—
Architect/Designers Address
Architect[Designers E-mail Address
1. _ .-
City F State �—
Zip F— Telephonel
ENGINEER'S NAME Last lY ( A 0
First 4i Lic. No.T7_1q9
Engineer's Address
Engineer's E-mail Address
4o t,1-0 �/ �k G-S`
j
City Sr,-f\ rG �.N� State
'I'll 9 �� DSTelepficnei 714 662 v �, b
r i Lic.No.�— CIasS�—
CONTRACTORSNAMElCOMPANY��t)S S I I pNC�� i j3%
Contractors Address
Contractor's E-mail Address
123r4—I C—✓�n/1 ova `v
LGus 4 a Cox ivl-';�'T
City) �M (� Nn State G
rip 197.:Telephonel14 <W (19�
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
PERMIT NO. i1 %i Sf- IJ
PLAN CHECK NO. '3L2p vL 7 a?
I I.CF 7nNF nFVFI OPMFNT NO PLAN CHECK FEES $