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HomeMy WebLinkAboutXC2022-1903 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ?fWCp, r Comml i- Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIMF nF: Rl IRMITTAI o. F-Building F_ Grading F-Drainage r Elec r-Mech F-PlumCu vd Cutl Cu Yd Fill F_ Project Address (Not mailing address) l- Flood r" Fire f Liq r Landslide FN/A Floor Suite No 0-1 N - _CeY,1-�r Ck Deescription of Work Use F—ConstType Rr__V T,q, e # Stories #Units (if Res) Valuation $ (1 7 Material/Labor y 6 New/AddSF�— RemodelSF�— Garage/New/Add - OWNER'S NAME Last First Owner's Address Owner's E-mail Address mine__ CornpcAN ReAin i 1_Prcir �ieS [3M(AChQ pirvilQeC,0 PCy)y. • CC)m City Tvv (n t' _.... State __Cl ..a Zip Telephon APPLICANT'S NAME Last ��i h LJfi� ► na5 First Applicant's Address Applicant's E-mail Address City aTce)it j1 C State— ZiP Telephone V.\6V ARCHITECT/DESIGNER'S NAME Last First �— _._ Lic No. Architect/Designer's Address Architect/Designer's E-mail Address — City State Zip F -- Telephoner ENGINEER'S NAME Last First F® Lic. Nor Engineer's Address Engineer's E-mail Address City State �® Zip �— Telephoned CONTRACTOR'S NAME/COMPANY i 5 Lic. No. t05'7 Class C�C� l • t03IL4 Contractor's Address Contractor's E-mail Address �1 j0 Li Tc, �-(tr G-,. ( C.arkys@ G5` C, 6 • GOm city ih State I �t� ZIP C� &q4 TelephoneW _. '- ZW(4 SETBACKS REAR SETBACKS FRONT PERMIT NO. XCZOZZ - L G © 3 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. P C, ZGIZZ'� USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 3