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HomeMy WebLinkAboutX2022-0201 - Permit Application�202Z- G201 Worksheet for Combo Building & Solar Permit Application j Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r—Building Grading (—Drainage iElec (—Mech F— Plum Cu Yd CutF-Cu Yd Filll Project Address (Not mailing address) [7 Flood r Fire r Liq r Landslide (-N/A Floor Suite Ni 0 7512 T_Description of Work Use F_ Const Type F R #StoriesF`L #Units(ifResl —��rrll Valuation$ F New/Add SF[— Remodel SF Garage/New/Add i Material/Labor OWNER'S NAME Last W First Owner's AddressO Owner's E-mai(Address City N State ZipC� , 3 Telephone 94 ` L, APPLICANT'S NAME Last 5M Ly First I I�/G4j& Applicants Address Applicants E-mail Address (--P, tv�V14—IyVL S(/pi a)�JN f�4t,( "1)- City � Zip l 1 I 11T)-s`telephone / Jam ARCHITECT/DESIGNER'S NAME Last ---fit First I Lic. No. �— Architect/Designees Address Architect/Designers E-mail Address City �— State �— Zip j Telephone7 ENGINEER'S NAME Last First R AJ61-1 Lic. No. �f _Tlg Engineer's Address Engineer's E-mail Address FIS -1c) CS,o©\e_ 1, 4o1%L vV 3 Lk-!�_ 1 I-- State I G � �— Telephone I // pp—t7�/f� Zip qT-)C,�j � 4 (70% CONTRACTOR'SNAMEJCOMPANY Lic.No. W7/440 Classy Contractors Address Contractor's E-mail Address I`:. '4`L cot Nti0ry a�rfZ 11�rt�u`s�w iI'o�CfliC,�I�-! State City �(� �— �- r� _ G( Zip 9� �(� �3 %OS Telephone�I ( I SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PERMIT NO. _ .41 PLAN CHECK NO. PLAN CHECK FEES $