HomeMy WebLinkAboutXR2022-2948 - Permit ApplicationPrint Form Work0eet for Combo Building & Solar Perm- it Application
j- Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) C Flood r Fire [- Liq l- Landslide CN/A Floor Suite No
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Description of Worker
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# Stories # Units (if Res)FT
Valuation $
Material/Labor
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OWNER'S NAME Last (�\S �Q� �� � � �,J.,(�First
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last First
Applicant's Address mej N Applicant's E-mail Address
City State Zip F—Telephone7—
ARCHITECT/DESIGNER'S NAME ^
Last ¢�J First Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last / First � Lic. No.�—
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Engineer's Address Engineer's E-mail Address
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City Ej State I E^ Zip _a11 - , L Telephone qT 'j)S—C)
CONTRACTOR'S NAME/COMPANY t✓r�� �UNlxi Lic.No. ZU Class
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Contractor's Address Contractor's E-mail Address
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REAR SETBACKS FRONT PERMITNO. XPZGZZ-e,9j�(dTBACKSLEFT
SETBACKS RIGHT PLAN CHECK N0.E
ZONE DEVELOPMENT NO PLAN CHECK FEES $