HomeMy WebLinkAboutX2022-1108 - Permit ApplicationPrint Form Wor et for Combo Building & Solar Permit Application (1-40
_ J pp
Comm'I FZ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FjBuiIding F_Grading ainage F_Elec F_Mech F—Plum Cu vd Cut[_ Cu Yd Fill F_
Project Address (Not mailing address) C Flood F_ Fire r Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use Const Type
# Stories #Units (if Res)
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Valuation 9
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New/Add SF� Remodel SF Garage/New/Add �
Material/Lab r
OWNER'S NAME Last 1 First szc—
Owner's Address Owner's E-mail Address
5 (ZvE . �7'Ib 'CALL _
City i (j Wr State I F ZipTelephone?
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APPLICANT'S NAME Last I C l� l First A(-tx�
1
Applicant's Address Applicant's E-mail Address
City C N ( State CA. Zip q ley t Telephone
HI ESIGNER'S NAME -Last ,�� �• First �' � Lic. No. �—
Architect/Desi er's Address Architect/Designer's E-mail Address I`
I�
City State � Zip � Telephoned
ENGINEER'S NAME Last First Lic. No.1
Engineer's Address Engineer's E-mail Address
City State �® Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY S�1^ I )(AV Lic. No. 629 JtL, Class _'
Contractor's Address Contractor's E-mail Address
City kW State (,A Zip C 1-;J4 Telephone ac)l Z L 3 G 5 79
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT N A�ajPLAN CHECK FEES $