HomeMy WebLinkAboutXC2022-2093 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
,v t omml (- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
PBuilding F_ Grading r-Drainage F- Elec
Project Address (Not mailing address
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Descri tion of W k
[Meth FPlum cu Yd catl Cu Yd Fill
F_ Flood [_ Firer Liq F Landslide F-N/A
Floor Suite No
P or
Use Const Type
VNew AW n I h I y �,y �y�ytu- ��c G �0 0 G�
I�.��terir� #Stories #Units (ifRes)F—
New/Add SFI— Remodel SFI-- Garage/New/Add I — Valuation
- _ Material/Laa
bor
OWNER'S NAME Last 1Q�Vii'l2 First v
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Owner's Address - - -
Owner's E-mail Address
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City ' 1pV I l' State , %N
-. G� ZIP Telephone
_ -. _- �-Z�-31vb
APPLICANT'S NAME Last �^_
I�IL)Z, lei l� First �r vvll_ _
Applicant's Address Applicant's E-mail Address
Wlingm..52 � � 6(hM co"
City ��jj��-j��j 1,�n � State �� / .- - "! r � ` w \ Zip qO%�b Telephone ?(0 &17-dZZZ
ARCHITECT/DESIGNER'S NAME
Last First l--
Lic. No. F —
Architect/Designer's Address Architect/Designer's E-mail Address
j-- City State
�— Zip Telep hone
ENGINEER'S NAME GC i�
Last vt c. First GeVs°.VI 1L0 Lic. No. G '7Z� 9✓- I �'
Engineer's Address Engineer's E-mail Address
77t &I? _ ()-e 50 f0 AVM cc® Yii lii l y/hecl�n C�n�
City / ��'n V �i State �� JJ ! - f l
l.Y�t r W S �ii �lil l `ir r Zip I y13aT,eiephone 0 e 4b—& —t7 3 �'/Y
CONTRACTOR'S NAME/COMPANY Y I 43 7�
' i �!� ��� Lic No. L � lass L(o
Contractor's Address Contractor's E-mail Address
city 1,50 Zk Qpta_ 5 ZVti @ UI2a6 • cc i,
State F2 - Zip Q� 27 Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO,
SETBACKS LEFT x �� Zo`13l
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE ncWPI nDnACh,7 nin