HomeMy WebLinkAboutPV2022-125 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F Comm,l F71Residential City of Newport Beach - Building Division P11
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL - WWI
FF-15'uilcling Grading [-Drainage 1-,Elec r- Mech [-Plum Cu yd cut F_ Cu Yd Fill F_
Project Address (Not mailing address) f-, Flood F_ Fire F7 Liq 17 Landslide F -,.N/A Floor Suite No
Abbe 011 Brie, nh 7 F_ F_
of Work
New/Add SF Remodel SF
OWNER'S NAME Last
Owner's Address
Use F_ Const Type FZ�
# Stories [-2- # Units (if Res)[—
Valuation $
Garage/New/Add Material/Labor
F
First
Owner's E-mail Addr
ess
City StateTelephone
O j '�/L c7 33 -1 /-Z-
F�� ZiPF' 2
APPLICANT'S NAME Last
Applicant's Address
93-3 N,�co" _�;� ,
City F State
First
Applicant's E-mail Address
I
JI w@ brt_W'1 i.4
Zip GJ24Z7 Telephone 9108 4-0 eT
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. F
Architect/Designer's Address
City State F_
Architect/Designer's E-mail Address
Zip Telephonel
ENGINEER'S NAME Lasti Do L,5 FirstF Lic. No. FE(e,�) Z
Engineer's Address
5- q(61
Cit y I 1-o"State F
Engineers E-mail Address
CLCA4
910�0
Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Er5-I,f- L-V�e FE �zt
Contractor's Address
CitYF__ �j4,, �//)U
State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address I 192A24, T
Z 1 P��4,7 Telephone� ' Di
PERMIT NO. -k,/2412- 12.5,
PLAN CHECK NO. i -2,+V .2ozz-
USE ZONE — DEVELOPMENT NO PLAN CHECK FEES $