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HomeMy WebLinkAboutX2022-1438 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application oc-"°Ra Comm'I F_ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL L� wilding r Grading rDrainage N-Elec F1Wech 'Plum Cu Yd Cuts Cu Yd Fill Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide F_N/A Floor Suite No 5iijl45 tj1�-Wi?®V-T C4=,rjr� bR. I I Description of Work Use FPI Const Type # StoriesF # Units (if Res)s (Aj l T ) `J P ty Valuation $ Material/Labor / New/Add SFF— Remodel SF Garage/New/Add �— OWNER'SNAME Last lnVjp3r �,y,np�,�� First Owner's Address Owner's E-mail Address 10 8mA G iv.\JitJ U MpAWr ►M _ City State I Zips— Telephone LLj,�,-?Zj_ .3)A?e APPLICANT'S NAME Last �LA11,LF First t� (�fyrL Applicant's Address Applicant's E-mail Address OtP LL l;0 "A )N C.. N Er- City State Zip F_ Telephone l L1. 35-2. -7-5Ie ARCHITECT/DESIGNER'S NAME Last OA/AirOG4fl O First No. CZ a� 3i Architect/Designer's Address l �Lic. P7I MDU N Architect/Designer's E-mail Address �1� �t 1' City State F Zip I Telephone t' ENGINEER'S NAME Last I �First SA mr 4j Lic No. �i72 y5 Engineer's Address Engineer's E-mail Address City State Zip F Telephone GZV , 9 ZJ , ? 0 e 1 CONTRACTOR'S NAME/COMPANY Jc il�V oq 1''�� _ CC,;� S pU� CW 9j5(��(Q Class d Contractor's Address Contractor's E-mail Address ID- 6- (-A'T_> Cd fE 1 Srt r--F_ b I P, J klA 6,fp CDIY\ City ��CRD b' t--' State Zip 3 57, Telephone (z Q2 7 00Z-. 'TBACKS REAR SETBACKS FRONT PERMIT NO. /1 ;�Op; ;? "I el3E TACKS LEFT SETBACKS RIGHT PLAN CHECK NO. )NE DEVELOPMENT NO PLAN CHECK FEES $