HomeMy WebLinkAboutPV2022-025 - Permit Application (2)pant FoGm ,"' Worksheet for Combo Building & Solar Perrni1611icptto
Comm'II Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Address (Not
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Description of Work
Ins��\1 ion of ro�fjno 641K ( YOC f6`<W / lgbo Ic
New/Add SF�I Remodel Garage/New/Add
OWNER'S NAME Last
Owner's Address
First
Owner's E-mail Address
❑N/A Floor Suite No
Use F-1 Const Type VT
# Stories # Units (iflRes)[7
Valuation $
Material/Labor
w-- -0 -"r\-- e(r't-C---
CityC6(@(lq-L^--mgj - -- ---State Zip ���� Telephoned
APPLICANTS NAME Last �(Jpp�Cn�C q- ------ - -J First -- - - - -------.-- --
Applicant's Address 1 �J Applicant's E-mail Address
I`6231 51v�Zor��11s—�L�_1ntl���lle __ — NZ4_185N?�
City l�f�1 -G------State ZipTelephone 5i L � --
ARCHITECT/DESIGNER'S NAME Last First
�Lic. No. ---
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last ( First F Lic. No.F_ __ 7
Engineer's Address Engineer's E-mail Address
City ! — State L Zip[ ' Telephoned
CONTRACTOR'S NAME/COMPANY 1�}l� Lic. Noj�aa0 - Class _01P� ii
Contractor's Address Contractor's E-mail Address
City � � — — State Zip rI q Telephone5�y ;9,u3
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $