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HomeMy WebLinkAboutX2022-1553 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application off RA\m - Comm'I 7/Residential of Newport Beach - Building Division o !_ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `` u F uilding r Grading F-Drainage F�Elec r Mech F>/Plum Cu vd Cut F_Cu Vd Fill F_ Project Address (Not mailing address) F_ Flood (- Fire F_ Liq r Landslide F_N/A Floor Suite No v8 8t /609 � �eJ 2s zv Si Description of Work Use Const Type 1/d `SF2 �2� 4/✓ .f:a // eo✓rrl �14 l6 /0i v e�,, # Stories #Units (if Res)r— ie.' 7 Valuation 2 0 �� Material/Labor J / � New/Add SF yZd Remodel SF 2SI 2 Garage/New/Add � OWNER'S NAME Last i cP First I e",.t Owner's Address Uc Owners E-mail Address /1 /�Jo, �ovrf (`rr•,r,j/r <��d ne�.ro.., City ,�/cw o l tJc.cry State �� Zip 9266 j Telephone (6/f> y/j, ,362y APPLICANT'S NAME Last /e / /f O First e / �� Applicant's Address Applicant's E-maidress // City G<r�n �sraK State cq Zip y2�y/ Telephone 9,31-v9y-z.��t ARCHITECT/DESIGNER'S NAME Last �� First Lic. No. Architect/Designers Address Architect/Designer's E-mail Address City State I Zip F_ Telephoned ENGINEER'S NAME Last �%/� <� First �<� Lic.No.l (6�739 Engineer's Address Engineer's E-mail Address 3yy/ /r�,� City [6., State v� Zip 24YJ03 Telephone y3y_,j�y_2J.y CONTRACTOR'S NAME/COMPANY Lic. No. / p0_T1 Class G t «brj Contractor's Address Contractor's E-mail Address >Z6/ A-,'. �/+c c. �✓c. U .� T �/� ✓ems! �«, �� -/.. Kr,(. row City /Z, �e.. w. State c-A Zip F1260. Telephone �/ '3-.02 7 SETBACKS REAR wc4<7TBACKS FRONT PERMIT NO. SETBACKS LEFT q SETBACKS RIGHT L/ PLAN CHECK NO. y/ 73 USEZONE DEVELOPMENT NO PLAN CHECK FEES $