HomeMy WebLinkAboutXR2022-2300 - Permit ApplicationL. Print Form j Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
<omm'l F LResidential tu:
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI
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Fteuilding Grading F—Drainage r— Elec F_ Mech Plum Cu Yd Cut F_ Cu Yd Fill F_
Project Address Not mailing address) F_ Flood F_ Fire F_ Liq [_ Landslide F_N/A Floor Suite No
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Description of Work xDA74i,4-&0 1�877X1'71d-'V'
Useg' j/Const Type
# Stories[—:?;, Units (if Res)j 7
11V A 1--t 4 'V -t) CT�l 4- /,,'b 15' /3 11v e, z, z , A S
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Valuation $
Material/Labor
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New/Add SFF ReA4edi2TSFj Garage/New/AddF___
OWNER'S NAME Last /-5- 4///f/ 0' First
Owner's Address Owner's E-mail
City State zip F77777 Telephoned_
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State Zip 1 IZZWO Telephonel e
ARCHITECT/DESIGNER'S NAME Last First Lic. N _7 _2__"
Architect/Designer's Address Architect/Designer's E-mail Address
City State -zip-[— Telephone
ENGINEER'S NAME Last First F_ Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State F_ zip Telephonel
CONTRACTOR'S NAME/COMPANY Lic. No. ClassF
Contractor's Address Contractor's E-mail Address
City State zip TelephoneF_
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $