HomeMy WebLinkAboutXC2022-2083 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar. Permit Ap 16 tion�`""°gr
City of Newport Beach - Building Division
j Comm'I [j Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
JBuilding []Grading [Drainage [�,Elec Y}Mech Plum cuYdcuF71 CuvdFiuFI
Project Address (Not mailing address) ❑ Flood IJ Fire ❑ Liq [_Landslide �N/A Floor Suite No
D
of Work
New/Add SF _ 11 Remodel SF rj -7_ J Garage/New/Add
OWNER'S NAME Last
Owner's Address
City f=Vi)/F,- State 7T2
APPLICANT'S NAME Last
Applicant's Address
City 0pm/a -- State
First
Owners E-mail Address
Zip I /'Ltyl 1 Telephc
First I ► k_i?-K
Ap{plicanVs� E-mail Address
!j1,',I 7r.+,.-(I\q�1
Zip I (I J_&(71 /Telephone
ARCHITECT/DESIGNER'S NAME Last
Architect/DesignersAdddres/s
City I o ) i�I pe OF/ E d State F (-",_
Use i �ConstType
Stories[] # Units (if Res)C�
(Valuation$ y �QOO�
Material/Labor I
First - �:h(L- Lic. No. z.
Architect/Designers E-mail Address
i
Zip C�,.gC Telephone
ENGINEER'S NAME Last _ _ First - Lic No.177
Engineer's Address
I
City -- — State-�
Engineers E-mail Address
II
Zip �l Telephone(
CONTRACTOR'S NAME/COMPANY j i Lic.No.FX1 d ClassR-K-1,11
Contractors Address
CityI'�Ir ��.T ,.,�Ls.�- State --(^Y -�
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractors E-mail Address
/WG/Fi�Ticc�.coM
-, p - —
Zip g'2 6 g Telephone / �- , -aft
�-�__��
PERMIT NO. Z03J
PLAN CHECK NO. 2_,7'1�j
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $