HomeMy WebLinkAboutX2022-1052 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm" Residential City of Newport Beach - Building Division �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
uilding I— Grading rDrainage j—Elec FMech r Plum Cu rd Cut] Cu Yd Fill
Project Address (Not mai+li-ng
address) F_ Flood r Fire F- Liq r Landslide F_N/A Floor Suite No
Description of Work
Use F—Const Type
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#Stories #Units (if Res)
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Valuation $
Material/Labor
New/AddSF�— Remodel SFF Garage/New/AddF
OWNER'S NAME Last F
First so-vt te"I
Owner's Address
Owner's E-mail Address
50 � T� , r
.S i '(YLO , Ga m
City 1 0 Q uJ Utz YJ' k
State F` Zip F'[5� Telephone l 7 ) -77w
APPLICANT'S NAME Last
M50� First m A•i' Y--
Applicant's Address
Applicant's E-mail Address
City I i C J I nK-
®� State I® �_Ji Zip q" N Telephone l i q 31 '6 00
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip Telephoned
ENGINEER'S NAME Last
r ym�sFirst ma+-h av Lic. No.1 T 6571
Engineer's Address
Engineer's E-mail Address
2-6 Is�t'n
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City Nh (x (eW1
State Zip C/Z� G Telephone .jd ._ �Q
CONTRACTOR'S NAME/COMPANY
Lic. No. �j��JW Class S L- j,
V
Contractor's Address
Contractor's E-mail Address I T6005-7M 1 "31 "Tvz3
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City r v h _e_
State c.,A Zip q7 & 4 Telephone 7/Cf % ?(0L 3()
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. Itall- — lost
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. Q q 6 7 - Zd VZ
USE ZONE
nrvri OPMFNT Nn h 9d 0 -D414 PLAN CHECK FFFc e