HomeMy WebLinkAboutM2022-0019 - Permit ApplicationPrint Form i I Worksheet for Combo Building & Solar Permit Application '°
F Comm'I ✓Residential City of Newport Beach - Building Division PoWl- 0011 n �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUFII,r,�
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Project Address (Not mailing address) � Flood F_ Fire r— Liq F i Yw�
PEIT Suite No
790� Lola
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Description of Work
Use Const Type
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Material/Labor
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arage/New/Add
OWNER'S NAME Last 4;4 //,,
First COI' C
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Owner's Address
Owner's E-mail Address
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Zip jeo ri 3 ...Telephone 9®/ 7
APPLICANT'S NAME Last �6tc K for?
First I /L'
Applicant's Address
Appliliccant's E-maililAddress
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ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect(Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephone
ENGINEER'S NAME Last
First r, Lic. No.F—'
Engineer's Address
Engineer's E-mail Address
City F_ State F
Zip F— Telephone
CONTRACTOR'S NAME/COMPANY J ( AAee ,/ Lic.No. �026 q ClassF
41,914 S4Orr /�rArme�Onfrrf/C�Oh
Contractor's Address
Contractor's E-mail Address
City rn�jRyIeA 11f'WL(� State C
Zip 9ZCY� Telephone �eZ -�q2
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ftI Zelt- oo i q
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 14(J2' WL-&
USEZONE DEVELOPMENTNO P?Ot9- C)553 PLAN CHECK FEES$ 3R0.00