HomeMy WebLinkAboutXC2022-2011 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
omm'I F— Residential6 �) City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIMF nF SI IRMITTAI
F,, Ilding F Grading F`JDrainage �_Xlec F—Mech F�Plum Cuydcut- CuvdFill
Project Address (Not mailing address) 1! Flood r- Fire f Liq r Landslide f N/A FloorSuite No
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Description of Work
Use Const Type (Cl
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! L/W Fw 2 Sjj It kvI>trnz
# StoriesF # Units (if Res)[
I%yAt a-dke il_arar'ae �aY��J/tiws
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SFF—Remodel SFGarage/New/Add
Valuation $ egNew/Add
Material/LaboFii
OWNER'S NAME Last ��1�(� t�lA�Pity First Ceioor L� t
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Owner's Address
Owner's E-mail Address
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City �VSfiN State F— Zip T2 /vU Telephone 07,733 : 624
APPLICANT'S NAME Last F.;bli - First (f s ��� /-�� h
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Applicant's AddressApplicant's E-mail Address eI✓0
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City <F c State F� Zip f v<� Telephone d j ICY? Z,
ARCHITECTIDESIGNER'S NAME )! I i „� /
Last (, /� G f k First a ( Lic. No. e'er
Architect/Desiipgnner's Address Architect/Designer's E-mail Address
City I Alf// State ZIp �j� Telephone] �17'j
ENGINEER'S NAME Last y�Yt°61 First �%I Lic No. 7Q4=
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Engineer's Address Engineer's E-mail Address
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City (4� dmP,, f7,yG State Zip -72&y j Telephone '7/4' `41�,+S-- 5;;oD
CONTRACTOR'S NAME/COMPANY Lic No. �— Class
Contractor's Address Contractor's E-mail Address
City State I Zip F_ Telephone
SETBACKS REAR SETBACKS FRONT PERMITNO. LCJI
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No. rC 2f 2,2--ZSLt 6
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $