HomeMy WebLinkAboutXR2022-2822 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit A Ii ation
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F_ Comm'I F_ Residential City of Newport Beach - Building Division )qaAr-a- -
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_ Grading F-Drainage F7 Elec F_ Mech F- Plum Cu Yd Cut F Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq - Landslide F_N/A
F Floor Suite No
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c Bz
Description of Work IV& 6) ,v /2-rf, 7-o A X T/d,-V
UseConst Type V-14
Vf1
iesFe # Units (if Res)
# Stor F�
/L=/S lWe-
. . . ........ . . . . . . . . . . . . . . . . . . . . . . . . .
. . .
New/AddR Garage/N
SFJ Z 5:f ew/AddF
ion $
Valuation 0r
Material/La 11/v
Material/Labor
OWNER'S NAME Last Vf First
Owner's Address Owner's E-mail Address
State
. . . ........ . Zip[- --- Telephonel
APPLICANT'S NAME Last -x First
Applicant's Address Applicant's E-mail Address
. . ............ . . ..
City 6&1250A, t AV D State Zip Telephone l
ARCHITECT/DESIGNER'S NAME Last 12AAII'�y_ First /I/v 10 Lic. N
Architect/Designer's Address Architect/Designer's E-mail Address
V ;_e
City -State- Zip, Telephone
ENGINEER'S NAME Last First F_ Lic. No.
Engineer's Address Engineer's E-mail Address
... ....... . . .....
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. Iq 5 6 '?q 3 Class
Contractor's Address Contractor's E-mail Address
City State F® Zip Telephone F
SETBACKS REAR SETBACKS FRONT PERMIT NO. XR2WZ- ?_3 2-2-
SETBACKSLEFT SETBACKS RIGHT PLAN CHECK NO. PCZ0Z2_- 2-6S I
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $