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HomeMy WebLinkAboutX2022-0468 - Permit Applicationx2o22oy�� Print 1 orr�, Worksheet for Combo Building & Solar Permit Application [ Comm" Residential City of Newport Beach - Building Division \ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL T41Building [Grading F]Drainage ❑Elec FMech EjPlum Cu YdCut n cuvdFiuF %ProjectAddress (Not mailing address) [7Flood ❑ Fire F]Liq M Landslide ❑N/A Floor Suite No 27t��) r I -/A11 - Description of Work Use onstType� # Stories # Units (if Res)U] Valuation $ New/Add SFF—,j;:� Remodel SFF� Garage/New/Add L Material/Labor OWNER'S NAME Last Owner's Address First Owner's E-mail Address City _ State Zip Telephone) APPLICANT'S NAME Last Applicant's Address _ _r_1 t7 P -)Ox IL6 City TVA_ _ State First Applicant's E-mail Address �ifZ� (�tl9�IL C{n7M Zip Telephone 9 , ARCHITECT/DESIGNER'S NAME Last I v7�First Architect/Designer's Address City _ _ State Lic. No. p7RW Architect/Designer's E-mail Address Zip [77777 Telephoned ENGINEER'S NAME Last C9�01� 2-F'j�- First ©� 9 p Lic. NoT ____7 Engineer's Address City C _ 1 t� State ((� Engineer's E-mail Address Zip _g "33'�j Telephone 94c? e e5_" Z. CONTRACTOR'S NAME/COMPANY // Lic. No.Class / Contractor's Address - 140 i� % ox -2� ] --- - city Nei ,kp�,l State _(�� SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's EE -mail Address LOt.Jc-yul�a�rl��7�N/�lL. Ppm Zip Telephone 7/y A, V -VS p PERMIT NO.� PLAN CHECK NO. UV I USE ZONE DEVELOPMENT NO PLAN CHECK FEES $