HomeMy WebLinkAboutX2022-1342 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permi Application orEW�R>e
F_ Comm'I [Residential sion
NOTE: PLAN Hrt E Ko EBESaDUE AT TIME OF uilding iStIRMIT n, `,�b
City of - r.�
uilding [,Grading r—Drainage F7 Bee r'Mech r-. plum Cu Yd Cuts Cu YdFiu
Project (Not mailing address) r Flood r' Fire F_ Liq j" Landslide rN/A Floor Suite No
%%Address
-1771
Description of Work
Use � Const Type
4
CJ ?
# Stories # Units (if ResF
New/Add SF�—' Remodel SFF --
Valuation $ dtl
Garage/New/Add—erial
j Mat/Labor
..
OWNER'S NAME Last�— I ��� /
SC.tC
First 5 (Lib„
Owner's Address
Owner's E-mail Address
City "_.- State FEK Zip 1 �i � Telephone 66—a\ _
APPLICANT'S NAME Last '50 g_y
First
Applicant's Address
Applicant's E-mail Address
LS C 16�— _- vy
City _,...�'"`� l gE� State
Zip r�(J(��„ Telephone
ARCHITECT/DESIGNER'S NAME
Last U t Gr�c 4 Vl l lq First CC&,'� Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
�l.t(D SL cel �i ......
-State
w�� . t��j�1 o r'� . Cc ,
Cit
.��
p `� - Tele hone
ENGINEER'S NAME Last V TYGLCJ
First -C��j Lic. No. ls;
Engineer's Address
Engineer's E-mail Address
City C ll l\� / State CI )
Zip (�CX . j2 Telephone L%,�1' A0 n ZI 7�zzI
CONTRACTOR'S NAME/COMPANY E �l � J Jyr� Lic No Class
�J
Contractor's Address
Contractor's E-mail Address
City �_.._ __. _... State F
Zip �— Telephoner.
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO. '2_Co2 "7l lq
USE ZONE DEVELOPMENT NO �7 ?-o .03 SZ PLAN CHECK FEES $
Ci -e\12 -z-07 7 S
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
949-644-3200
PLANPROCESSINGREQUEST
ADDRESS:
DESCRIPTION: {u D
(LCV I SIok )
PLAN CK #:
❑ NEW ( OTC / APC / SUBMIT) /1'7 Ktk
❑ RESUBMIT ( recheck / pro s RFI) O i L-
ZIREVISION (delta #2
pc hrs. )
# of PAGES (plans li% x11 ct'-1c'C'�1
BLDG STATUS: AP / PA / CO PP --SrC
-�IIA2 crenic.
DEPT/DIV REVIEW NEEDED: (circlerequire s)
PLNG PW EMP HARBOR FIR GRADING
Engineer: date:
Contact Name & #:
FarmslP1anPm1essin9Request