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HomeMy WebLinkAboutXC2022-2124 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application (N-P r r Comm'I Residential City of Newport Beach - Building Division �(� � 7 ! NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT Building r Grading rDrainage r Elec r,,Mech x Plum CuYdCut s CuYdFill Project Address (Not mailing address) F_ Flood r Fire F_ Liq F_ Landslide FN/A Floor Suite No � Fzx' zv0 2'j24 S� SR-IS'f"UL ST Description of Work Use p�d:aEonstType V—A n/6w� V6at 4rry iVitLt-, /NT_ FAlzriTirwr , pe1Iz S f}tdl ISU•ES� LjsD N4u #Stories #Units (ifRes)� S °Kt� Z Frwr(ttlEr F1Xt R pLKM61N� t P6`'�2�HIL valuation $ New/Add SF Remodel SF Wga'L 5r. Garage/New/Add Material/Labor F30, OWNER'S NAME Last TY1� YR�S GeHyifN/ES -€irsi GeNTiYr-'rr 1-1q-Q.1� 41{ Owner's Address Owner's E-mail Address 1'I IT-1- M t_ Ot City i � i N � State Lb Zip Sur I Z Telephone 9411- ycf-zr1 F APPLICANT'S NAME Last SPRS pL++��f�✓C� F st DSsI 4� Applicant's Address Applicant's E-mail Address 3/m l?ry15'TVL STD S rFi 26r— aYIU� er�acei—Uc• Ls+.r City Gps} /1./. ',} State T/ Zip �2G2V Telephone gtl9-��-�Lo ARCHITECT/DESIGNER'S NAME rW c l 4 Last Ply-�6R-� First Lic No. Architect/Designer's Address Architect/Designer's E-mail Address 3r�u 6RISTTrs, s'�S� S-y ac,cJ—ac • cu..••, City L6rT-7t- µ,/ J4 State Zip 9 wl,,- Telephone F179� Ymay_ cf6y9 ENGINEER'S NAME Last 6R 1 First FT soft s Lic. No.F— Engineers Address Engineer's E-mail Address 'Vin e r-arELc.A- ate, sr� 8�s— sev;�.b�lteexi — ca- City /F.Nx-� H State Zip qTelephone 7�y, ycLi yVy(o CONTRACTOR'S NAME/COMPANY Lic. No. L 067 qI Class Contractor's Address Contractor's E-mail Address City I State F_ Zip F_ Telephones SETBACKS REAR SETBACKS FRONT PERMIT NO. kC Z-cJ✓cam (�� C� l SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $