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HomeMy WebLinkAboutX2022-0187 - Permit Application1 Print Form _ Work,,,3homet for Combo Building & Solar Permit Application Comm'I City of Newport Beach - Building Division X pP �, j! Residential ��Z Olo NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ;Building r7 Grading r Drainage ry. Elec [Mech Plum cu vd cutl Cu Yd Fill Project Address (Not mailing address) [i Flood r; Fire [i Liq j! Landslide [N/A L;�er, �-e � _���► ivy Description of Work `Zed New/Add SF�— J Remodel SF Garage/New/Add OWNER'S NAME Owner's Address Last r Z t'`� r"- ] First ��Ir Owner's E-mail Address .0 (', rti�-2r City I 1.)...,.. _L I gtntc C,4 Zip I ZLeIoO1 T --- --- -- Floor Suite No [Tk Use Const Type # Stories # Units (if Res)7 Valuation $ Material/Labor �� (,l APPLICANT'S NAME Last t" Lv )" - -_ � First �•�es._re.n Applicant's Address t-t cvr► tv.le J Vim. CityvS}� —J State —J Z Z- Applicant's E-mail Address Zip 2(o Telephone (� 102C&I ARCHITECT/DESIGNER'S NAME Last --__---...1 First-7 Lic. No. Architect/Designer's Address City .--- - ---- -- -- — — ---� State Architect/Designer's E-mail Address - --- -- ----------- zip Telephone ENGINEER'S NAME Last �j �, First Lic. No. Engineer's Address 2C4S 1-k,-c-arr^�t�k �tyelc�e. City State CONTRACTOR'S NAME/COMPANY Contractor's Address ^ City S State Engineer's E-mail Address Zip Z,� Telephone 0114)Ssz-2,2Z, Lic. No. 1�p(c{ (� Class�� Contractor's E-mail Address \— o Zip Telephone (7t �)352_uz SETBACKS REAR SETBACKS FRONT SETBACKS LEFT USE ZONE SETBACKS RIGHT PERMIT NO. �� PLAN CHECK NO.