HomeMy WebLinkAboutX2022-1301 - Permit ApplicationTint Form L Worksheet for Combo Building & Solar Permit Application oNEW°°ar
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G<'oa ,.
wilding [ Grading Drainage r Elec F_ Mech r' Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire j— Liq r Landslide FN/A Floor Suite No
('01 vin �� V I F_
Description of Work
Used Const Type
# Storiess # Units (if Res)
Valuations l� 0UV
Material/labor �
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last �)Ga AGa'7 First
Owner's Address Owner's E-mail Address
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City "Cr � c/z_. State F 6 Zip Telephone 751.
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APPLICANT'S NAME Last �, h WI f First
Applicant's Address Applicant's E-mail Address
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city �V N_� State Zip �( `t%h-� Telephone
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ARCHITECT/DESIGNER'S NAME Last a 2 First Lic. No� ) �—
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Architect/Designer's Address Architect/Designer's E-mail Address
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City r' }IN. State Ey'd�Zip qrLt,I Telephone
ENGINEER'S NAME Last First F— Lic No.F—
Engineer's Address Engineer's E-mail Address
City State Zip �— Telephone—
CONTRACTOR'S NAME/COMPANY (fl Lic. No. � Class
Contractor's Address Contractor's E-mail Address
City I1"E State 7 Zip t I Ql TelephoneMq
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SETBACKS REAR SETBACKS FRONT PERMIT NO. l`ZG ZZ 1301
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 26 I 'ZUZ `Z-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ Z661 6