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HomeMy WebLinkAboutX2022-0194 - Permit ApplicationxZp22-OI Gl Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division F- Comm'I j- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F -Building Project kotE 1 F- Grading r -Drainage F- Elec Address of Work 1, r- Mech F— Plum cu Cu Yd Fill mailing address) C- Flood F- Fire F- Liq F— Landslide I _N/AFI� Su Use F_ Const Type # stories # Units (if Res) Fie IValuation $ 9 $ � i' New/AddsFF— Remodel SF�- Garage/New/Add �— Material/Labor OWNER'S NAME Last W t Vlj-ll First Owner's Address Owner's E-mail Address C3, O i, '� -P t z aY N C�Q S -SM i C It City ... State I Zip 92 _ a Telephonej 7 9 t 19 APPLICANTS NAME Last S(h i yl,4- Applicants Address �'1 i 4 L rZW14D tJ Chy S �� C� y ,n State ARCHITECT/DESIGNER'S NAME Last Architect/Designers Address First 1 1144V CiV S Applicants E-mail Address Zip g;1,—) p Telephone -% 11.1 S- 3 `z3 C I C1 1 First Architect(DesigneYs E-mail Address Lic. No. 7— State- State F_ ZIP Telephone City �------- ENGINEER'S NAME Last x 1 A © First II (� N Cj Lic. No. � S `9 Engineer's Address Engineer's E-mail Address i 59-t7 �St o+� c t� Oyl:t7w5 it, nn �--- -- C \ R State Zip j Telephone) �) 41 �-� Lic.No. Lj3 440 ClassI kS CONTRACTOR'S NAMEICOMPANY jI &t) % fA I TI'$ 60N_5'C Contractor's Address Contractor's E-mail Address 1� 3C✓k�-. CA U'M[o 0 alt t w^� city State J_1 /5{'r R' 3N t Telephone]�j SETBACKS REAR SETBACKS FRONT PERMIT NO. X 1`l SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO _ PLAN CHECK FEES $