HomeMy WebLinkAboutX2022-0634 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Perrtyj�� V W
F Comm'I 1 Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI ..,.oa.•
F_. 9 9 1-177 u Yd Fill L
wlding Gradin ;Drains a ,Elec Mech Plum Cucuvdcut
Project Address (Not mailing address) F! Flood. f— Fire F-1 Liq F, Landslide F_N/A Floor IISuite No
Description of Work
I (Z//7 iq-
New/Add SF�
OWNER'S NAME
Owner's Address
MIFI
RemodelSF1 JI Garage/New/Add —I
Last I Ger Igcic�l /i 1 First I
APPLICANT'S NAME Last
Owner's
State I Zip
Applicant's Address
City _I State
Address
Use 17 Const Type
# StoriesF! # Units (if Res),,
Valuation $ s - -
Material/Labor
ARCHITECT/DESIGNER'S NAME Last !II First, Lic. No. �I
Architect/Designer's Address
City _. State
Architect/Designees E-mail Address
Zip F Telephoned
ENGINEER'S NAME Last �— First F777777 Lic. No.F77-777
Engineer's Address
City �.. — State
Engineer's E-mail Address
Zip � Telephone
Zi I
CONTRACTOR'S NAME/COMPANY I Lic. No. �, Class F_
Contractor's Address
City State F777
Contractor's E-mail Address
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Zip Telephoned;
SETBACKS REAR SETBACKS FRONT PERMIT NO. — 0 (,?j "1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. _57 S - L -t-) Z Z
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $