HomeMy WebLinkAboutX2022-0950 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application 0�0
r Comm'I Residential City of Newport Beach - Building Division o
o. n., ruary cops nI1F ATTIMF OF SUBMITTAL
FBuilding r— Grading F-DrainageVr Elec )—Meth r Plum Cu rd Cuts Cu Yd Filll
Project Address (Not mailing address) C Flood Fire F,, Liq F— Landslide F -N/A Floor Suite No
Description of Work Use Const Type I vo
(—� # Stories # Units (if Res)s
-- Valuation $ I Ia flF'1T� ,...�
New/Add SFsRemodel SF Garage/New/AddI Material/Labor I VJVVVV
OWNER'S NAME Last S �G� �`q' First � \er( o_,�v
Owner's Address Owner's E-mail Address
v ZtAA 1,0\(\- 0%
�
City � State F( C� Zip � 6 — Telephone) —
APPLICANT'S NAME Last r 17 I_+ First sfv&,u,�
Applicant's Address _ Applicant's E-mail Address
l�rQ3—/4\,`—����[�io✓
Clty11 1'v vt�t ii✓ State �C — Zip i7 D� Telephone lW (( �(
ARCHITECT/DESIGNER'S NAME Last First s__ Lic. No. s—_
Architect/Designer's Address ArchitectlDesigner's E-mail Address
City State F— ZiP F— Telephone�—
ENGINEER'S NAME Last— First ( (� � Lic. No. Q
Engineer's Address Engineer's E-mail Address
3-o %Q-oo j140rL UV/
Telephone %/4 0
City rip I SRJN
.
CONTRACTOR'SNAME/COMPANYw&-us �(A t rt CarVS j Lic. No. �`r(�(� Class
Contractor's Address Contractor's E-mail Address
l�—
Ci11 e, �y /� State Zip 'I Telephone
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
PERMIT NO. X-10 U7 0,1 G-4
PLAN CHECK NO. Al(! 4mal/
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $