HomeMy WebLinkAboutX2022-1787 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
Comm'I j— Residential City of Newport Beach - Building Division
NOTE PLAN CHECK FEES DUE ATTIME OF SUBMITTAL
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FBuilding F_ Grading rDrainage r—Elec J—Mech
r Plum Cu Yd CutF- Cu Yd Fill 1
Project Address (Not mailing address') Flood
( Fire F- Liq i— Landslide F_N/A Floor Suite No
Description of Work
Use F_ Const Type
N S u O C� I 1U
# Storied # Units (if Res)!
'NL A
Valuation $
Material/Labor)
New/AddSF�Remodel Garage/New/Add
OWNER'S NAME Last S�(.�V""stt✓
First)
Owner's Address
Owner's E-mail Address
/U WI 1_k-�
City I M?_, _ State C (A
Zip C Telephone 94 q 3) 07V
APPLICANTS NAME LastS(W1-y-1`t
First il/(yU5
Applicants Address
Applicants E-mail Address
I1.342 CA+v�1DN � e=2C�Gt�
�
city R n State 1 f A
Zip 9 2� '7 h S Telephone) �1 9 1 t 9,
V
ARCHITECTlDESIGNER'SNRME Last �—
�—
First �— Lic No.
Architect/Designer's Address
Architect/Designers E-mail Address
city State F
Zip �— TelephoneF—
ENGINEER'S NAME Last F
First Lic. No. �}. g9 f�
Engineers Address
Engineers E-mail Address
city c N� State —
Zips 9 )� j�S Telephone 7I4 661 (Bs -lb
�(wt\I CDNSt Lic No. G3_7ltE{b Class
CONTRACTOR'S NAME/COMPANY
N&US
Contractors Address
Contractor's E-mail Address
i 23 42 Cwty i Dn�
City C NK,� (�N� State I
Zip'C�`1�� TelephoneFT4 51S t 1q �
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. AV22- 611$ l
PLAN CHECK NO. I " — 202,2
USE ZONE DEVELOPMENT NO __ PLAN CHECK FEES $