Loading...
HomeMy WebLinkAboutXR2022-3354 - Permit Applicationaria Form ` ;) Worksheet for Combo Building & Solar Permit Application Cc 00-913-2Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIMF OF StIRMITTAI. [Building [Grading [-.Drainage [Elec F-Mech FPlum cu yd cut F Qvd Fill Project Address (Not mailing address) F_ Flood F- Fire F- Liq r Landslide [N/A Floor Suite No Description of Work Use ConstType� n y'�- - M/ (. se r' tG .��re 1k,,,9 f #Stories #Units (if Res) Valuatio/ .Material/La orZ 0 e>I ! ' New/Add SF�— Remodel SF�- Garage/New/Add � OWNER'S NAME Last LC Sa;N-*11_&�u'r� LLGFirst- Owner's AddressOwner's E-mail Address City 1Vj-5 t/n h{ t �/ - State tj Zip / 3 G 2 Telephone % 7.Z APPLICANT'S NAME /� i Last !/�^ First Applicant's Address Applicant's E-mail Address _- 5 City State C -- Zip , ! Z %bs Telephone 7(y-%27.. y/ ARCHITECT/DESIGNER'S NAME Last � ndjt First /l�i7c/1J`l Lic. No Architect/Designees Address Architect7Designees E-mail Address City State F— -Zip F7Telephone— ENGINEER'S NAME Last First Lic. Nol_— Engineer's Address Engineer's E-mail Address - . _ ------- - _ City State Zip Telephone�— CONTRACTOR'S NAME/COMPANY Li?LRec. No. (OZ73�g Class Contractor's Address Contractor's E-mail Address Z27% 5.. C7rWNc/ /j(/t ! `i�yelr� !1/ti'YGtf-,Bran -GD - city Via ANG ..-_ - State C�— Zip . �2 Jp� Telephone 7/rj ..%Z7 ?75 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $