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HomeMy WebLinkAboutXR2022-3008 - Permit ApplicationPnnt Form Worksheet for Combo Building & Solar Permit Application swpo Comm'I Residential City of Newport Beach - Building Division �� i NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT LZ�22 C7</FpptP Building [ Grading [—Drainage F_ Elec F_ Mech Plum Cu Yd Cut F_ Cu Yd Fill Project Address (Not mailing address) (- Flood F- Fire F_ Liq F_ Landslide I_N/A Floor Suite No F-L37- ­­j(�1_,,_V­i_> ...... ...... Description of Work /mac- f' r +o t-jtD. ir--- T OF (C-) F/(.2,sT-1v1� New/Add SF Remodel SF Garage/New/Add F- OWNER'S NAME Last J lVTG6�� . -- ......._ First --f 1 Use F Const Type F # StoriesF_ # Units (if Res)F— Valuation $ (9 Material/Labor Owner's Address Owner's E-mail Address ......_ 1 y ���D- - .._' State City - G Zip ':1 Z�p:j 7_Telephone _ _-.__.._._------ _ Architect/Designer's Addres�ss Architect/Designer's E-mail Address City �'j State Zip l-'7-Al-e7 Telephone -7(t � ENGINEER'S NAME Last G� f First Lic. No],,,,-�37 ... _.... .. .. - --_._ Engineer's Address Engineer's E-mail Address 161 !�-I City , State ZipTelephone _ ..... _... - p Z r,6 CONTRACTOR'S NAME/COMPANY C'_IS S Co h '� i 0 n t Lic. No. 't3 D'� `� Class Yi ens -: Contractor's Address Contractor's E-mail Address _ __ s--QY v,r City _ t2�' (+ J\.........__ _ State e Zip a� � Telephone SETBACKS REAR SETBACKS FRONT 1-)/�/ $ to PERMIT NO SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PLAN CHECK NO. W T� /1) PLAN CHECK FEES $