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HomeMy WebLinkAboutX2022-0196 - Permit ApplicationF— Comm'] Qn-1-Dlei lR Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division F- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuiilding F- Grading F -Drainage i Elec Address (I 1=N L In of Work F- Mech j- Plum Cu Yd r Flood F- Fire F- Liq r Landslide Cu Yd Fill I F -N/A Floor Suite N( i— Use Const Type # Stories I # Units (if Res)r ' I Valuation $ 1 0 New/AddSF�— Remodel Garage/New/Add�— Garage/New/Add Material/Labor OWNER'S NAME Last Owner's Address `_© l jkt'�� I D &7C j �"T First O f'r- Owner's E-mail Address Citiy 1.1� i .. - State Ic `t' .. Zip I q U)6.1 Telephone1949 631 n 9 xs�__ APPLICANTS NAME Last 15 M t l t,t Applicants Address City 5PN-VR (. N_ ARCHITECT/DESIGNER'S NAME Last 01111WIMPA Applicants E-mail Address Zipq� 7 D Ste„ Telephone First I Lic. No. �— Architect/Designer's Address Architect(Designer's E-mail Address __ _. - -. _- - --- -.. .. City I State �— Zip I TelephoneF ENGINEER'S NAME Last �� First I lI Lic. No. � }..� 9 Engineer's Address 5.910 QA0D4140�A,(DvV City 5 (�N r1- (� v (\-- State CONTRACTOR'S NAME(COMPANY Engineer's E-mail Address Zip I Telephone '�)G -10 �Ie.t7S rC4�.Go �vSY Lic. No. 6340 Class Contractor's Address Contractor's E-mail Address 1 J34`1 N bn/ ti�f( �1/c�u sr vrr1(4 43Gv)(- V 1:11 i CityState C� Zip (� �7®�` Telephone 71 ! 5' 9 . i I-1 SETBACKS REAR SETBACKS FRONT PERMIT NO. X SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO _ PLAN CHECK FEES $ _