HomeMy WebLinkAboutX2022-0533 - Permit Application (2)IL2rn�orm� Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division X WZZ . 0(; ;21
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F5Building ❑ Grading FDrainage ❑ Elec
Address
Description of Work
l( e
n Mech r7 Plum Cu rd
F] Flood rFire n Liq [I Landslide
New/Add Remodel SF�I Garage/New/Add
OWNER'S NAME Last
Owner's Address
143 Ne t{aaft rola------_----_
Cityljeu�--- �ac11 --I State
APPLICANT'S NAME Last
Applicant's Address, n
City 4r_+9� t ---Noe
-- ---- -- State I SAY- J
First
Cu Yd Fill
1-N/AFloor Suite No
I---------!
Use I I Const Type F
# Stories # Units (if Res)F7
Valuation $F, �, 00 D - -
Material/Labor V
Owner's E-mail Address
--
Zip
i First
Applicant's E-mail Address
Zip I �! Telephone(y
ARCHITECT/DESIGNER'S NAME Last , First
Lic. No.
Architect(Designer's Address
I
City - — - - State F777
Architect/Designer's E-mail Address
Zip I J Telephone 7
ENGINEER'S NAME
Last!First Lic. No. %
---------- - - --- - -- --- - x 5 72
-
Engineer's Address
City CSj_fZc, State I �
Engineer's E-mail Address
Zip c� yah 2 Telephone $kq) 52r . 99111
CONTRACTOR'S NAME/COMPANY Lic. No. f02lOr Z_ Class T e.Z
QS NST-1�C-T( a r\)�s3_J
Contractor's Address
City .SIV ' State
CA -
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
- -5 ��� ��/�t -LH_
Zip x%2 3_-i Telephone FY-9)�5-$3 A6
x,4,"-4c-oS33
PERMIT NO. 0`t91-202 Z
PLAN CHECK NO. A R VII -0310
PLAN CHECK FEES $