HomeMy WebLinkAboutPV2022-0417 - Permit Applicationf�
E'urlD) Worksheet for Combo Building & Solar Permit Application ��E"'tea
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5�'0,�'
[-Building r',-Grading [-;Drainage [-Elec r'.. Mech [-.Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood [- Fire [-I Liq [-i Landslide [-N/A Floor Suite No
Z�, Me�•,su;( C43P\ I I —
Description of Work
Use ConstType
n I
iI( Pv OA-A.IZL w.4, 1.,,:c4v i/Wcf4erj roof-_
# Stories #Units (if Res),
Valuation
New/Add SFFT , v(C(,j Remodel SFF— Garage/New/Add
$
Material/Labor
OWNER'S NAME Last (T �Y Zr _ First
Owner's Address 1 Owner's E-mail Address
Z6 MxA Sf+i1 Or ...State
City �.(pa.6 QtI MAr..... �.: Zip 9y(�� Telephone'-}�(�.-.Li�2-Liq�'�-
APPLICANT'S NAME Last �j a.-bc --', First Vi
Applicant's Address Applicant's E-mail Address
�33 gew�,rbl St I ViA@ 6/,jl41-js'- SGIA'C.COM
city (0344 MeS a _ ... State I � Zip , z,6 Telephone q D 8 -4$1-.3N33
ARCHITECT/DESIGNER'S NAME Last c,"Ma as First Lic.No.�—'
Architect/Designees Address Architect/Designees E-mail Address
City �— State F_ Zip F Telephoned
ENGINEER'S NAME Last M6laiZ.i ! First TD Lic. No. FT, i Zs _
Engineers Address Engineer's E-mail Address
S Vic, BGI Ame_
City P_Aoc�o 5p.t, MA�)4,1?4 State I V Zip Ue$$ Telephone 949-245--$/69
CONTRACTOR'S NAME/COMPANY I7 �.�� f �• /t ,44, Lic. No. i pZq'Lbi Class .(3,
J
Contractor's Address Contractor's E-mail Address
City State F_, Zip r'. Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. '?Y Uj,% I 0 11
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. '?G2Vjj_ "3oV2-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $