HomeMy WebLinkAboutX2022-0998 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'1 jkResidential City of Newport Beach - Building Division 11
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c /
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Project Address (Not mailing address) r Flood r Fire j— Liq r Landslide F_N/A Floor Suite N
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Description of Work 21 LF y 13Gu� `VZ�
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# StoriesF_ # Units (if Res)
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Valuation $
Material/Labor
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New/Add SF�— Remodel SF Garage/New/Add
OWNER'S NAME Last (mac r e l 1 First e Wre y
Owner's Address Owner's E-mail Address
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City t3� Po izz aOf5r StateFa a Zip 45-7 Telephone '7/(75ys-- //D�y
APPLICANT'S NAME Last( (�(�� ( First ?r" t;
Applicant's Address Applicant's E-mail Address
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State Zip �J Z(� 3 Telephone 51�q . Cp s3.5 Q (o/
City FT RVE �L ��
ARCHITECT/DESIGNER'S NAME Last First F__ Lic. No.
Architect/Designer's Address Architect/Designees E-mail Address
City State F_ Zip F— TelephoneF—
ENGINEER'S NAME Last Avid First Lic. No. � Y� Z
Engineer's Address Engineer's -mail Address
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City V (^)V State FC(� Zip 26l8 Telephone[?
CONTRACTOR'S NAME/COMPANY Lic. No. Class L2�
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Contractor's Address trac%Ts E-mail Address
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City State �f /� Zip gJC3 C) Telephone %`i�qo� .ZjZ�
SETBACKS REAR SETBACKS FRONT PERMIT NO. Xtou , GI" / oq,1q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 091&/V x/
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $