HomeMy WebLinkAboutX2022-0295 - Permit ApplicationPnnt,Fotm °` . Worksheet for Combo Building & Solar Permit Application
City of Newport - Beach Building Division g
[,' Comm'I V Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building F_Grading Drainage ❑Elec 7Mech 7Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) El Flood [ Fire [ Liq [— Landslide F_N/A` Floor Suite No
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Description of Work
Use C ConstType F_OQ
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# Stories? # Units (if Res)r—
Valuation $
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New/Add SFF Remodel SF� Garage/New/Add F
OWNER'S NAME Last �L,gDp First yr�
Owners Address Owner's E-mail Address
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City Nt'cuFb'cY ejWff State FM Zip 9� Telephon
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APPLICANT'S NAME Last First ze"- e-r
Applicant's Address Applicant's E-mail Address
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City �,State, Zip 9Z>�503 Telepho
ARCHITECT/DESIGNER'S NAME Last �— First— Lic. No.
Architect/Designer's Address Architect/Designers E-mail Address
City �--- State F_, Zip F_ Telephone—,
ENGINEER'S NAME Last First L LiC. No.
Engineers Address Engineers E-mail Address
City State F Zip [— Telephonel-
CONTRACTOR'SNAME/COMPANY w1 �2!�r117 Lic.No.3 Class
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Contractors Address Contractors E-mail Address
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City state eF zip R z5,15 Telepho ��
SETBACKS REAR SETBACKS FRONT PERMIT NO. K?C 2 Z- OZ4 S i 1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. OZG S-Zo22, l ,
USE ZONE DEVELOPMENT NO PI AN CHFCK FFFS S 214 - -7 -7