HomeMy WebLinkAboutX2022-0185 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application 47 -pope
F comm" r idential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
iIding rGrading F–Drainage rElec rMech r, Plum
Cu Yd Cuts Cu Yd Fill F
Project Address (Not mailing address) r' Flood r, Fire r'
Liq r Landslide rN/A Floor Suite No
Descri tion W rk
'I
UseConst Type FI
if Stories! # Units (if Res )s
J
Valuation$
Material/Labor F2-�n �7
New/Add SFF— Remodel SFs— Garage/New/Adddd F—'
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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millp V11 IV
City
State Zip
Telephone
APPLICANT'S NAME Last
First
i l U r
Applicant's Address
Applicant's E-mail Address
City 1
FM'
State l,// 1 Zip
lll///�/ 1
Telephone
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ARCHITECT/DESIGNER'S NAME
Last Firgf –—
ArchitecUDesigner'sAddress
Architect/I
Pr®marionafl
Jolson Glib1
Sales & Proj
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City _..... _ _..
'.,. State �—. Zip
Manager
ENGINEER'S NAME Last
�. First I
(714) 540-5454 Phone 3301 S. Susan Str
Santa Ana,
(714) 540-5959 Fax
92-,,,
Engineer's Address
Engineer's
(714) 330 2446 Cell
r—
igilbert@promosigns.us License No. 636:
City
State Zip �--
Telephone
CONTRACTOR'S NAME/COMPANY
JAILic-
No. RZClass71--
Contract 's dress
Contractor's E-mail Address
_
City
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State F Zip
_.
Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. /�tou-61 S6
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK N0.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
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CA
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