HomeMy WebLinkAboutX2022-1533 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
C— Comm'I r Residential
NOTE:
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building F_ Grading rDrainage F Elec
r Mech Plum Cu Yd Cuti Cu Vd Fill j
Project Address (Not mailing address) Flood (— Fire i Liq Landslide 1 N/A Floor Suite No
1 qWz-b4C -r
Description of Work
Use ConstType �—
i G t�
# Stories #Units (if Res)7—
Valuation$I�
Material/Labor
i
New/Add SF F— Remodel SF
Garage/New/Add'
OWNERS NAME Last i_N%QaCnZ\ G ST First
Owner's Address
Owner's E-mail Address
City p! c2 State
! Zp Telephone,t%lfcl — �
APPLICANTS NAME Last 1 S jArTXy-
First! f--kivGyLya
Applicant's Address
Applicant's E-mail Address
City ,,.s �'�.N.�i State
Zip i Or �'7QS� T—elephone (— g
l /First
ARCHITECT/DESIGNERrS NAME Last
Lic. No.
ArchitecVDesigner's Address
Architect/Designer's E-mail Address
Ci State
�— Zip �— Telephone�—
ENGINEER'S NAME Last
First; Q A N� Lic.No.is� Z,�
Engineer's Address
Engineer's E-mail Address
.�L
City State
_ Zip ��`�(jS Telephones"�1( � f� 1-000NTRACTOR'ScRA,v`
I`S
NAF-M�E/ICOMPANY i C_-�- /' Lic. No. 37440 Class i a
Contractor's Address
Contractor's E-mail Address
City 5RN—f* State
Ir�C Zip '��-tom Telephone-7l4
eereerrte oFna SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO ^_ PLAN CHECK FEES $