HomeMy WebLinkAboutx2022-0717 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
n Comm'I KResidential City of Newport Beach -Building Division X2,QZ2'-0T1-+ C
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building ❑Grading [Drainage ❑Elec []Mech [,Plum cu yd cut Cu Yd Fill
Project Address (Not mailing address)Flood C Fire [ ! Liq r Landslide ❑N/A -7i FFLLIoo��r Suite No
Description of Work
Use 77 Const Type L J
# Storiesn # Units (if Res)F7
Valuation $ �, o ,—,
New/Add SF� Remodel SF �1 Garage/New/Add Material/Labor1 LJ /V� -
OWNER'S NAME Last
Owner's Address
First
Owner's E-mail Address
P �I P_ --__--J
City N�Vv —�C�� ! State - r!— Zi Telephone
APPLICANTS NAME Last
Applicant's Address
City t1✓l�l��l u(fL State eA
--._...-- --- -- -- --- --- --- -�
First
Applicant's E-mail Address
Zip Telephone 1(u
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designers Address
City �— State [—!
Architect/Designees E-mail Address
--- ----- ----- -i - — - -- -
Zip IF-- TelephoneF
ENGINEER'S NAME LastF
First Lic. No.
Engineer's Address
City.._-- --- -_I State ! j
Engineer's E-mail Address
i
Zip— Telephone��
CONTRACTOR'S NAME/COMPANY O 4 AV Lic. No. jw�Z�6 I Class7
Contractor's Address
1381 i�1D oqqU _
City OUAW._ V/T L5V State
SETBACKS REAR
SETBACKS FRONT
Contractor's E-mail Address
Cki COO
Zip Inde j Telephone I l 1
PERMIT NO. x202 0717
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.