HomeMy WebLinkAboutXC2022-2067 - Permit ApplicationPrint Form I Worksheat for Combo Building & Solar Permit Application
Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Grading F-Drainage
Project Address (
Elec Mech F Plum Cu vd cut Cu Yd Fill
r Flood r Fire [_ Liq r Landslide
24146
rN/A Floor
77
Suite No
Description of Work Use 7—ConstType
# Stories # Units (if Res;)
New/Add SF �— Remodel SF Garage/New/Add F-77
OWNER'S NAME Last &Apj0 - First %' Aarixt
y _
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Owners Address Owner's E-mail Address
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City L Ly. e
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D41 \.-.. - State Zip .._W� 0 Telephone p�{1-...
APPLICANT'S NAME Last
Applicant's Address
City �M✓� L�4 State �—
FirstI AID saw _.-_-....
Applicant's E-mail Address
Zip �'05DS- Telephone
ARCHITECT/DESIGNER'S NAME Last j First— Lic No
Architect/Designer's Address I n
City✓Y(�y�CL State
Architect/Designer's E-mail Address
Zip Telephone
ENGINEER'S NAME Last First l Lic. No.7—
Engineer's Address Engineer's E-mail Address
City State F® Zip Telephoner
CONTRACTOR'S NAME/COMPANY P „^-1l ( rv- .t j bLic. No. lc;-
_ � LL Class
Contractor's Address
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City aU Ag r Vl zm State
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SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
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Zip Telephone � � � . 7 �'',P• ZoGj�`
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO _ PLAN CHECK FEES $