HomeMy WebLinkAboutPV2022-126 - Permit Application4 �'_ I Worksheet for Combo Building & Solar Permit Application ��`w°
_.. ��2�2zZ�VZ�
(— Comm I �sidential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `'••••"
r�ilding F_ Grading r -Drainage h,Elec F',Mech r Plum Cu YdCut F Cu Yd Fill I
Project Address (Not mailing address) Flood ( Fire I! Liq (', LandslideN/A Floor Suite No
Description of Work
Use F Const Type
l7 ~ l��rs 2 / 3. a�
# Stories # Units (if Res)[;
Valuation $
Material/Labor 6b 4 1, �
New/Add SF F Remodel SF F Garage/New/Add F
OWNER'S NAME LastImFirst
Owner's Address Owner's E-mail Address
p
CityaState Telephone 20l
APPLICANT'S NAME Last First60*V /I
Applicant's Address Applicant's E-mail Address
33 ./VuJam_ 5� �!I✓� AHA .4l ,
City CoS sk /IA .� :, State F� Zip �7 Telephone 908- Lj 81- 3y 3 3
ARCHITECT/DESIGNNE�R�''SSS NAME Last First F Lic No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City I State F Zip r— ---" Telephoner
ENGINEER'S NAME ����� � G�� 3,
Last First e Lic. . No
Engineer's Address Engineer's E-mail Address
��(�
,J V i f.-_ yrs.eu • l'c. _ _
�<_olQu� �c���,
,, q
City /y)_ ._tate r -p- Zip %�(� 8g. Telephone altfq.-
CONTRACTOR'S NAME/COMPANY Ct� t_ y �( /_o Lic. No. �O f�7 Class;
Y� C
Contractor's Address Contractor's E-mail Address
?,5-3 lv ew to G ( Si-
City _CRSS. % r c State F zip -"(?27 Telephorl `70t)4"
SETBACKS REAR SETBACKS FRONT PERMIT NO. 1V14M- 12b XZvfz• 13`)'0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 9il'I • �,02?/�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $