HomeMy WebLinkAboutPV2022-056 - Permit ApplicationaElF Worksheet for Combo Building & Solar Permit �Application
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Comm'I Residential City of Newport Beach - Building Division (n►►yyrr W 2 — / u
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U
r--4uilding j Grading [—Drainage [7,Elec {—'Meth r—,, Plum Cu YdcutF—Cu YdFill l
Project Address (Not mailing address) r rg (7 Landslide F /A�
n -Flood r Fire Li N Floor Suite No
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)escription of Work Use F Const Type 5W� r
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r—� �� —� #Stories; #Units (if Res)F',
Valuations
Garage/New/Add Material/Labo D 000New/Add SF�Remodel SF�
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OWNER'S NAME Last ��eY rtj513y� First (,Ck i,,Vrk
Owner's Address Owner's E-mail Address
Applicant's Address
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city �, J � State F c�i�
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City (— State
Applicant's E-mail Address
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Zip 9 27 Telephone Fqcl9 3 ZG 3Cla'L
First I Lic. No. F
Architect/Designer's E-mail Address
Zip F Telephone
ENGINEER'S NAME Last RrxN First Lic. No.F_
Engineer's Address
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City ( A„,,,,,rState
Engineer's E-mail Address
Zip I � Z_& .. Telephone q� _ 28, ,-5(0C(
CONTRACTOR'S NAME/COMPANY Lic. No. (1p2g2(Z Class � �
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Contractor's Address Contractor's E-mail Address
City � v alt L4 State G Zip , Telephon
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
9�g -Y%1- 39'33
x�iti, 0091
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PLAN CHECK NO.
USE ZONE DEVELOPMENT NO `���• �1y� PLAN CHECK FEES $
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