HomeMy WebLinkAboutX2022-1182 - Permit Application11 Print Form IWor t for Combo Building & Solar Permit Application
F_ Comm'I rl Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DU AT TIME OF SUB ITTAL
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Project Address (Not mailing address) G Flood F'' Fire (—; Liq r L rfdstide I`/A„ftloor<
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Description of Work �
IVICCJ% ili TCLli U W-wl Use ConstT e
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# StoriesF43—r-i # Units (if Res)
Valuation$ New/Add SF Remodel SF _
5 / f Garage/New/Add —I Material/Labor ��� �'0
OWNER'S NAME Last First IVZW jbU✓t -(C�iS V
Owner's Address Owner's E-mail Address
City Nx ti✓t State �I ZiP IG�P�4� Telephone
APPLICANT'S NAME Last First r` (�
Applicant's Address Applicant's E-mail Address
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City �— Ll State Zip A7 ((jl$ Telephone �(
ARCHITECT/DESIGNER'S NAME Last 6 �' Lic. No.
�yL First � �,pt� ^W
Architect/Designees Address Architect/Designer's E-mail Address
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City S�� <V1r�g D State C ZiP iii Dk 1 Telephone 4piq 'L9b 44s'PSr
ENGINEER'S NAME Last I ko yrt `) First Q." Cxk-&r Lic, No. -0
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Engineer's Address Engineer's E-mail Address
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City vL-A n �� Si-- State I vir ► Zip �, Telephone Ll�� . 3� . l &?77
CONTRACTOR'S NAME/COMPANY y� v J Lic. No. C� Class;
Contractor's Address / , Contractor's E-mail Address
City I NZ4))PtV� /® C&_C44 !, State[ Zip y';*& p Telephone g� . 33?J . 7014-
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. % a
PLAN CHECK FEES $
USE ZONE
DEVELOPMENT NO