HomeMy WebLinkAboutXR2022-2620 - Permit ApplicationPrint Form �Vorksbeet for Combo Building Solar Permit Application
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City of Newport Beach - Building Division xx Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT/�L�����
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Building (- Grading Drainage F_ Elec F_ Mech F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r" Fire (� Liq f— Landslide FN/A Floor Suite No
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Description of Work Use F—Const Type
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pem OV & O A; Lt- C),F W_ ( Tr_"e7-j # Stories? # Units (if Res)[—
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Valuation $
New/Add SF Remodel SF r Garage/New/Add �� Material/Labor i000
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
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City State F Zip Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-Mail Address
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City (j,n,p,� Gam.... - - _ State Zip 1�i8�CJ Telephone �I`1_ Z 7,3 `�8q tp
ARCHITECT/DESIGNER'S NAME La
Arch itect/Designer's Address f�` �,O
City State F—
First 16f/Y . _ Lic. No.
Architect/Designer's E-mail Address V
Zip Telephoned
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip � Telephone
CONTRACTOR'S NAME/COMPANY G G Lic. No. 1V5 b95j0ass�--
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Contractor's Address Contractor's E-mail Address
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City ®ri o G f_ State �`�,p�+- Zip clZB(ob Telephone C t tla7 3 _o�4(o
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. >>��
PLAN CHECK NO. :1:3: :
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SETBACKS LEFT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $