HomeMy WebLinkAboutX2022-1798 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application o�S,P,3
F_ Comm'I Residential City of Newport Beach -Building Division as I-?g
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 3
FL— uiIdIng F_ Grading
F—Drainage F_Elec i—Mech r Plum CuYdCut CuYdFill F
Project Address (Not
mailing address) F_ Flood r Fire r Liq Landslide f N/A Floor Suite No
Description of Work
Use Const Type s—
L
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# Stories # Units (if Res)s
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r U'/\ -� /Gn X C`�
_. ��J� C, ✓`-1 � 'C-_-/. G / ✓"F-fin. cr C. ✓-G:t- �'
Valuation $
New/AddSFI
Remodel SFF—Garage/New/AddF—
Material/Labor
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OWNER'S NAME
n First
Last �r'tiCLF C,
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Owner's Address
Owner's E-mail Address
City l uw� 4 if I
r State Zip [77— TelephoneF_
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APPLICANT'S NAME
Last �VI<,+G / First
Applicant's Address
Applicant's E-mail Address
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City j<
State �' va Zip Telephone (- r c/
�27v
i
ARCHITECT/DESIGNER'S NAME Last First F
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
—
State Zip F TelephoneF
ENGINEER'S NAME
Last First F Lic. No.F —
S�
Engineer's Address
Engineer's E-mail Address r
City
State F Zip I Telephone
CONTRACTOR'S NAME/COMPANY 1 < . L Lic No. I & c Class ' -2 c
Covv,{roc
Contractor's Address
Contractor's E-mail Address
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City j4 {� ; n ti
State L Zip G27., i Telephone F[t-(� 3C,
SETBACKS REAR
SETBACKS FRONT PERMIT NO. Y (5jZ
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
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DEVELOPMENT NO7,5) - c07�7 / PLAN CHECK FEES $