HomeMy WebLinkAboutX2022-0583 - Permit Application0522 2o'Z,; ON
Worksheet for Combo Building & Solar Permit Application City of Newport Beach -Building Division Comm I [' Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FIBuilding [Grading : [Drainage [KEIeC [Mech KPlum cuYdcut l CuvdFill
Project Address (Not mailing address) G Flood [ Fire [ Liq [ Landslide ❑N/A Floor Suite No
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Description of Work Use C ConstType I
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# Stories # Units (if Res)C
Valuations$
New/Add SF 4 d G. ZLi Remodel SF Garage/New/Add , Material/Labor
OWNER'S NAME Last AIJayNt3atip 'First Pub
Owners Address Owner's E-mail Address
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City Nt wp �; E'A :l State Telephone ,46 °lZp
APPLICANT'S NAME
Last vuAY First
Applicant's Address Applicant's E-mail Address
lg6L N. ST. ki cii l
City :3wrA a w State GA Zip q 4IQ( Telephone , l W I l!o So42j
ARCHITECT/DESIGNER'S NAME Last 1-rze14 First WiU Alt Lic. No. L311q�
ArchitecUDesigner s Address Architect/Designer's E-mail Address
1'6GG N U'EiSICL S'T �:k GHI$ - :� VJh1L lT2-G—N.G�t-�1
City Sgµ to ANA State � Zip lZ 10 Cm Telephone
ENGINEER'S NAME Last t f e N First Nlt t. Lic. No.[I t�
Engineer's Address. Engineer's E-mail Address
ZS� 0. V.JKlC" S1. 41:sGt NUu2UN�
city State GA Zip IZ$-I,, Telephone 1(sj Sv3 Nlg'l
CONTRACTOR'S NAME/COMPANY m h ` Lic. No. R4 070 Classy
Contractor's Address Contractor's -mail Add(ess
o� s ae � � _50_ iU Q oln tc�►^ ohs a :� .
City ac.Q C in State Zip N:2 jGO Telephone �� Y
SETBACKS REAR SETBACKS FRONT PERMIT NO. yC 70Z 2 ' iJ 5 9 3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 5 Z Z 202 Z
USEZONE DEVELOPMENT NO PLANCHECKFEESI iIUf1.7/