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HomeMy WebLinkAboutX2022-1596 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application ialiyz� City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL I__ uraaing F7Drainage j`Elec j-Mech Plum CuvdCut � Address (Not mailing address r- Flood❑Yd Fill / ) j- Firer Liq j- Landslide [_N/A Floor n of Work A -PdL -/&A 12y-�'r�er Flo' Pr �S �riTfL New/Add SFF - OWNER'S NAME Owner's Address L/Y/if/7v p140 6AV,0,,,y4 / d, -u � Const Type ILPUse% 2/ , Storiesl ,3 # Units (if Suite No Fad el SF 0HQ 5:F Garage/New/Add Valuation $ Material/Labor/ Last /L j��/1✓/ O -- First Owner's E-mail Address City State �- Zip — - Telephoned APPLICANT'S NAME ___ Last 7 fP-V A X Applicant's Address _ First A �y d%Z7AL 6 u A /l� Applicant's E-mail Address C� c�� f�aa� c�it�r City �dG/jp/J SJ _0 State A ARCHITECT/DESIGNER'S NAME Zip Telephone y-- Last FI/Z/j���Lf Architect/Designer's Address First _4VID >1 Lic. N Z Z jo Architect/Designer's E-mail Address city zip Contractor's Address City - State �- SETBACKS REAR SETBACKS FRONT SETBACKS LEFT USE ZONE SETBACKS RIGHT DEVELOPMENT NO Lic. No. gS67G3 _ Class[ Contractor's E-mail Address Zip Telephone PERMITNO. AU 2, PLAN CHECK NO. .or PLAN CHECK FEES $ 16 2. c( q