HomeMy WebLinkAboutXR2022-2733 - Permit ApplicationPrint Form _j Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building DivisionKf :�-22- - 17 S7
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
/ r — — Building Grading F-Drainage D<Elec F_ Mech F- Plum
Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire Liq [_ Landslide F_N/A Floor Suite No
3 3 Y 2. 2, - F
Description of Work
Use �vo Const Type
C 0 Y1 )A ce- vt-
Stories 7_ # Units (if Res)F
C A,>LAt,3-&,
.. . ......... . ...... .
Valuation $ 91 7 i-c'
Material/Labor
New/Add SF Remodel SF Garage/New/AddF—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
State F 4_1 zip Telephone
City F F(
APPLICANT'S NAME Last 1`5 C v- First 13 r
Applicant's Address Applicant's E-mail Address
11 ci lor A0 , , -
40
City Oe Ic C J State zipj Telephone 5-7 3
ARCHITECT/DESIGNER'S NAME Last First• Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
F7
City State I Zip TelephoneF
ENGINEER'S NAME Last First FEE Lic. No.
Engineer's Address Engineer's E-mail Address
"5 c 11 A-1
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city State Telephone
F Zip F 64 'i 7
CONTRACTOR'S NAME/COMPANYLic. No. 0 5 Class
Contractor's Address Contractor's E-mail Address
City State Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO,. ze—
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $