HomeMy WebLinkAboutPV2022-0416 - Permit ApplicationFvtoll -oq(u
I=nnxw om Worksheet for Combo Building & Solar Permit Application
r Comm'I Pj Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEFR nuF AT Tnnr= nF si 1annirrA1 U
F-Building r'Grading F-Drainage rElec r'Mech rplum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r, Flood r Fire r Liq r Landslide rN/A Floor Suite No
jq157 PP,, (+ �SG��2 �l F_ I
Description of Work
Use F—ConstType F_
16 PV rttodN�s w�l„ M7cn tHu'v+{/5/ r.>ofMo�cd �'(UfG, � rood
# StoriesF_ # Units (if Res)F—
valuation 12 Q�U
Material/Labor
New/Add SF j , qZ Remodel SF�— Garage/New/Add —'
OWNER'S NAME Last' -
s r o Icti First e OG
Owner's Address Owner's E-mail Address
IiIS Port ,fAJel _
City Mew pew _.. 3t-d- State �— ZIP I-- Telephone 3 to- qr- SSS?
( O
First APPLICANT'S NAME Last
i
b a FiA
Applicant's Address Applicant's E-mail Address
q33 fVew" St
Viol � bsiyl^i-�r`7e sol uY . C oar
City _.S,A r�(QSc, _.... ._ State �— Zip _926i __._. Telephone 7og-gvi-3933
ARCHITECT/DESIGNER'S NAME Last p�C
S 4,0lC4pf- First F_, Lic. No. �—
ArchitecUDesigner's Address Architect/Designer's E-mail Address
City ... State F Zip Telephoned—._.. _
---;
ENGINEER'S NAME Las OD,- ,les - First Dovq I <s Lic. No. 6q 1 63
_.
Engineer's Address Engineer's E-mail Address
S_ vi't, _gel`At4e
City K-Gwc�o SC.v14 N�tirgarr7 c State —' Zip q 26 9 8 Telephone
V _ — qNq-gas-,poy
CONTRACTOR'S NAME/COMPANY Br3L'I- t// 1T� :(e ('014r .. Lic No. ItZg2,, -+ Class l3,Z- K
J
Contractor's Address Contractor's E-mail Address
45 rPPI;C4wt
_
City State �— Zip �—, Telephone—.
SETBACKS REAR SETBACKS FRONT PERMIT NO. �?i2.� 04 1I4
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. It,��
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $