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HomeMy WebLinkAboutPV2022-025 - Permit ApplicationPrint Form Worksheet for Combo Building $ Solar PermiEpp iicaotit5 F Comm"�, Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F-IBuilding F,Grading rDrainage [Flet Meth rPlum cuvdcut F cuvdFn� III Project Address (Not mailing address) [i Flood _._ r Fire F, Liq n Landslide FIN/A Floor Suite No -tk1 Description o Work Use Const Type __I —1FV Ineoh4GNIA Of(�f 16{J !110'0 C y� f0`<.ln/ # StoriesFj # Units (if Res) Valuation $ �l ?3?— Material/Labor vv/ New/Add SFF___ _7 Remodel SFF777777Garage/New/AddF OWNER'S NAME Last— First --_-_-_- -LD1- ---- ----- ------------_1 Owner's Address Owner's E-mail Address City [G5,Mno, 'DLA O)o,( __-------]State �- -I Zi I Telephone APPLICANT'S NAME Last (�jp�tn�Gq -- l First Applicant's Address Applicant's E-mail Address City e State �1� �j�L U� 6- up -1 Zip (J� Telephone C ARCHITECT/DESIGNER'S NAME Last First �- Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip I Telephone ENGINEER'S NAME Last First Lic. No.7_77 Engineer's Address Engineer's E-mail Address City State Zip Telephoned; CONTRACTOR'S NAME/COMPANY Lic. No ii)�gao Class GIS 13 G31 covoinvA Contractor's Address Contractor's E-mail Address a CSS a� m�hvers'l� �j2q W_( lM� - State Zip Telephone - SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $