HomeMy WebLinkAboutM2022-0012 - Permit ApplicationUse r ConstType
# StoriesF_ # Units (if Res)_
Valuation $
Material/Labor ✓(J DC7c�
Last %/ First
-
Owner's Address _
Owner's E-mail I Address 0 {
city 1 I-- .-_��,t cq ST
State I'r (,�^ -� _L; ,
- 1 ......_ zip Il
APPLICANT'S NAME
Last
Applicant's Address
city p
INw State
—
Print Form J Worksheet for Combo Building & Solar Permit Application �EWPoR,
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °
FlBuilding F- Grading Draina a
g FElec F-Mech F Plum Cu vd cut j�
Cu Yd Filll ,
Project Address (Not mailing address) F_ Flood F- Fire F- Liq F Landslide F__N/A Floor
%� , D �� Suite No
Description of Work
w
New/Add ---__._.._-----
SF Remodel SFF�
- - --- Garage/New/Add
OWNER'S NAME
First IL C
Applicant's E-mail Address
Zip 3 Telephone 74 2 7 r7
___.-_.
ARCHITECT/DESIGNER'S NAME
Last First �—
Architect(Designer's Addre � A� d � A P L � ,e rl% Lic. No.
6'C ArchitecUDesigners E-mall Address
City _
State F— Zip Telephoner
ENGINEER'S NAME Last �
- FirstFPE Lic. No. C Crtp�c f
Engineer's Address
Engineer's E-mail Address
G/ o�SvcTrN�Y N94
�/ - ._�.
City G c, �f �0 State -
C Zip z& ! 7 Telephone 714.. `l ! F . 7JT Z.
CONTRACTOR'S NAME/COMPANY
l� ��Nt7tnlnl f Lic. No. �Class
Contractor's Address
Contractor's E-mail Address
City -
State �— Zip � Telephone�c
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO. M Z022 " QQ' Z
PLAN CHECK NO. 1�ZGZ2
�JZat 0�+�6 PLAN CHECK FEES $ _ l� Zr UO