HomeMy WebLinkAboutX2022-1226 - Permit ApplicationF-1 Comm'I
Worksheet for Coml o Building
Wesidential
City of Newport Beach
NOTE: PLAN CHECK FEES DUE
& Solar Permit Application
uilding Mf sion
IME,AFiSUBMITTF(L
rBuilding Grading r,Drainage ❑ ElecF-] Mech F -j Plum CuvJ
Project Address (Not mailing address) [! Flood [; Fire CI Liq �I
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Description of Work
1-40- scWYIC cMa W,;gIZ 14fa.p- y;z" #15h,
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New/Add SF - -- ---------------i Remodel SFF777777 Garage/New/Add F7777
OWNER'S NAME Last p5 /N //L f�R_j First Aj(
Cu Yd Fill
Floor Suite No
7( 31�
Const Type n
# Stories # Units (if Res)
Valuation $
Material/Labor ����
Owner's Address Owner's E-mail Address
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Ci
ty POR r J f k - -- State Q27
Zip Telephone
APPLICANT'S NAME Last
C[iwZ%� First
Applicant's Address
3" con �n�ar� PLaz.� l �o j
City State C.a
Applicant's E-mail Address
Zip gZFf6D J Telephone 9Yq + JI?- 18o0j
ARCHITECT/DESIGNER'S NAME Last (0R XVVp+ti �)e V( First I Lic. No.
Architect/Designer's Address
/SI Do/y2 VE_ G.j
City I COSiA P/I4 State Ci4
Architect/Designer's E-mail Address
Zip g262i Telephone[7
ENGINEER'S NAME Lic. No.
Last C/V/L SC.y1�Qs First F77777
Engineers Address
2805 egx,'tia cep/STK.r--- a/?
City State I _.'
Engineers E-mail Address
i
Zip 4JU 77 i Telephone
CONTRACTOR'S NAME/COMPANY47rex Sox evx-ir jLic. No.
Contractor's Address Contractors E-mail Address
I3 can pa pore p142A 15V
city �/�WPowi �i lyC�/ State I Zip 9�G� Telephone 9'/q IV-
--
SETBACKS REAR �r SETBACKS FRONT / PERMIT NO. !
SETBACKS LEFT
3 r
SETBACKSS RIGHT /
PLAN CHECK NO.
USE ZONE
Z
DEVELO i/� /
PLAN CHECK FEES $