HomeMy WebLinkAboutXR2022-2128 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I f Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMiTTAi
F-Building F_ Grading F-Drainage j-Elec FMech F- Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) [ Flood i- Fire F_ Liq r Landslide F_N/A Floor Suite No
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Description of Work
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# Storiesr 2 # Units (if Res)
Valuation $
Material/Labor 2.Q/ o00
New/Add SF f Remodel SF Garage/New/Add �—
OWNER'S NAME Last
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Owner's Address Owner's E-mail Address
City (l�u {D 4b State (�c Zip q' O Telephone
APPLICANT'S NAME Last ?)q-uP-) p�-C-OE. First \�(_
Applicant's Address Applicant's E1-mail Address
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ARCHITECT/DESIGNER'S NAME Last 12-Aj2VyJp First
Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last First Lic. No .
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Engineer's Address 'Sri 3 Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY C�Q «`�S rT��V SLicNo. szkbivass�
Contractor's Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. X KZC>ZZ- 212 8
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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