HomeMy WebLinkAboutX2022-0198 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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[-Building F- Grading (-Drainage r-Elec rMech
F- Plum Cuvdcuti Cu Yd Fill
Project Address (Not mailing address) !- Flood
F" Fire F- Liq F- Landslide (-N/A( Floor Suite N(
I
Description of Work
Use F Const Type F
# Storiesl' # Units (if Res)F
Valuation $
Material/Labor79-00
SFF— Remodel SF[ — Garage/New/Add F—
New/Add
t,� i
OWNER'SNAME Last w:v w—i>Oq`V- C .Cv First)
Address
Owner's E-mail Address
jOwner's
City State I _
Zip C1�I 6 � Telephone qG`� '3i 0 '
APPLICA1 IIS NAME Last First 7Z C.Z-
Applicants Address
Applicants E-mail Address
117r 4`-1 Ct'Atv'Ao%J
�IVcgiJS�t Ckl�Cv �d=•`�
city I C _ _ ^ N _ -. _ State I /' /1. Zip �l � � Telephone S-5? l f7)
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ARCHITECT//DESI-GN\rEFVS NAME Last �—
First 1 � Lic. No. �—
ArchitectMesigners Address
Architect(Designers E-mail Address
City State F—
Zip F— TelephoneF—
ENGINEER'S NAME Last X)� First V' Lic. No. �Z
Engineer's Address
Engineer's E-mail Address
cit N ; �� State �—
Zip I C)2�- Telephonei 1!p bb -1 0
CONTRACTOR'S NAMEICOMPANY � � S �
t I WC, i Lic. No. 3-7114) Class
Contractor's Address
Contractors E-mail Address
1-1 442- Cdr N y 0t4�ti
; ; (� ! G) ,; P✓a�'
State
city I ` f�v'iN.
Zip � ��a� Telephonel �}
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $