HomeMy WebLinkAboutX2022-1535 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
i— Comm'] F- Residential
NOTE:
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building F— Grading F—Drainage F— Elec
F— Mech
Plum Cu rd cut Cu Yd Fill
Project Address (Not mailing address) f Flood
r Fire F— Liq i Landslide I N/A Floor Suite No
7- F---
f_s =-,-- G-r
Description of Work
Use [_ Const Type IF—
# Stories Z # Units (iif Res)F—
Valuation 5
MateriaVL borF* � 11 00
Remodel SF �— Garage/New/Add
New/Add SF
OWNER'S NAME Last V��a]2 S i First i
Owners Address O
Owner's E-mail Address
1b0 it�i:li� �T
1
city
''; (i sRr
p
ZP C--6 j Telephone!-�,s. 949 6 I f 9 S'
APPLICANTS NAME Last j Jtr r (�
First;i V�U�
Applicants Address
ApE-mail Address
1'i,3(,1 1V pt�i i
lilicants
{p
i 1 tiaJCyUSSt^� iz;ex-
City VAN State i
(fit-r Zip Irjl� QS Telephones-
ARCHITECT/DESIGNER'S NAME Last i
First Lic. No.
Architect7Designers Address
7.
Architect(Designers E-mail Address
City State
I
Zip �— Telephonel—
ENGINEER'S NAME Last!
First j t) 1 aN(::9' Lic. No. Sad
Engineers Address
Engineers E-mail Address
157-D &ZOOv-t4bu o\A/,
14. S
i
City SAt �CA State
j
Zip191�70� Telephone 1
CONTRACTOR'SNAME/COMPANY NHS Sjr Tt4
i
�NSZ Lic No. 1j37(f4b Classi�—
Contractors Address
Contractors E-mail Address
1`1342 CPN 4L?iv i v:
city �`R �W State
ZiPj �705 Telephone! 1 4 S� - lit
SETBACKS REAR SETBACKS FRONT PERMIT NO. x — 15A 5
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. MOTIS
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $