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HomeMy WebLinkAboutX2022-1072 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application rl/Comm'I r'Residential City of Newport Beach - Building Division X2ci2,i--W,`2 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r�ilding F_ Grading rDrainage r,Elec rMech F_ Plum CuvdCut Cu Yd Fill Project Address (Not mailing address) r, Flood r Fire r Liq r Landslide rN/A Floor Suite No /cAG / 1&. Oxy Description of Work W,41—eO % %LL jQ Jt �F' �l✓l% UseConstT e /f yp # Stories#Units (if Res) 14-1 /ei,P eV A�lif7 %LC��GAG'r ,Sjrr%�/'�l� G�f! %�/z/�, /iy ✓GI.�Sj� r �71-11 It/ //(! l ;fes-_/lU�2�y�©�v/� � STC'.' — - - - � — � 'z rt, New/Add SF�', �errrodel SF % /7(% S� Garage/New/Add -- --- Valuation $ Ua Material/Labor // OWNER'S NAME Last 4 /a�//J/Z cel? First Owner's Address,� -Wrier''s-E-mail Wdd ress City L... ---' State — -- - -- Zip _.'I Telephone APPLICANT'S NAME Last/� jjf/y X First \.jA v Applicant's Address Applicant's E-mail Address d �z lbA4,0 v,C AV -9 City /6%Z/®,v,4 /�.,vD I State A Zip Telephone _.- s ARCHITECT/DESIGNER'S NAME Last �r%/i/%,L First y Lic. No Architect/Designees Address Architect/Designer's E-mail/ Address city State � Zip Telephone ENGINEER'S NAME ' Last First F Lic. No.F Engineer's Address Engineer's E-mail Address City _ _. State I— Zip �— Telephone CONTRACTOR'S NAME/COMPANY Lic No. Fq-% 7413, Class 13 Contractor's Address Contractor's E-mail Address City State F__ Zip r—--. Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. X �� O% SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Lj USE ZONE DEVELOPMENT NO PLAN CHECK FEES $