HomeMy WebLinkAboutX2022-0850 - Permit Application' �ttfi6 Worksheet for Combo Building & Solar Permit Application
F Comm'I ('! Residential City of Newport Beach - Building Division Xall- UqD
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
jjBuiIding F -! Grading [-Drainage f-Elec
Project Address (Not mailing addre:
F,; Mech rPlum. Cu Yd Cut Cu Yd Fill
F_ Flood f- Fire r Liq F_ Landslide
New/AddSFF— Remodel SF F— Garage/New/Add
OWNER'S NAME
Ow�n/ers, Address
1)
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APPLICANT'S NAME
Last First
rN/A Floor
Suite No
Use F—ConstType
# Stories # Units (if Res),
Valuation $ J`Ca - 2 , ODD
Material/Labor�ivNeB n2/,DDr
Owner's E-mail Address
State Zip
Last First
Applicant's Address Applicant's E-mail Address
9 `� 3 /L u c)dw 5T s br y�F/rhe sb lw+r cwt
City C-05 4� ww,�- State F2 Zip 1 0J2 -4Z? TelephoneF;R.- 32z 31(02-
ARCHITECT/DESIGNER'S NAME Last First
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephoned
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ENGINEER'S NAME Lasto q
First Lic. No. GGpY/!n ?j
Engineer's Address
Engin/eer's E-mail Address
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City State Zip
e Af�2
&600 Telephone
CONTRACTOR'S NAME/COMPANY V r ¢ ! & Lic. Na Class c,{
Contractor's Address Contractor's E-mail Address
City CoS /v ti State CZip o&Z_7 ^ej+sphone gfj3_gW?-39'
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
/�" ' X1 77
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $