HomeMy WebLinkAboutX2022-0021 - Permit Application (3)W she t for Combo Building& Solar Permit Application
Co mm'I Residential(
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City of Newport Beach - Building Division
NOTE: A qADz
PLAN CHECK FEES DUE AT TIME OF SUB L
f_ -,Building F_ Grading \_, raalnage Elec Nlech 1plurn Cu Yd Cut Cu Yd Fill
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Project Address (Not mailing address) F_ Flood r Fire F- Liq F- Landslide XIA Floor Suite No
E A� 4L (f A) Z? 6 -
Description of Work
Use Const Type
17
# Stories # Units (if Res)
New/Add SF Remodel SF Garage/New/Add
Valuation $
Material/Labor
OWNER'S NAME Last First
Owner's Address Owners E-mail Address
L J3,
City State ZiPF-;T Telephone=
APPLICANT'S NAME LastFirst
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Applicant's Address Applicant's E-mail Address
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City State Telephone 6
F7 zip F7 1-7-T'i
ARCHITECT /DESIGNER AM 'S NLast First
se'.1oL, ct S A'/) :7 i . E -- ------ -- F77777 Lic. No. I_
j- j --- 6 .. ......
Archltecl/Designers A dress Architect/Designees E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last Y6 Firsti Lic. No.F—
Engineers Address Engineers E-mail Address
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City State s® zip I TelephoneF77777
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractors Address Contractor's E-mail Address
City State Zip F_Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N6.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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