HomeMy WebLinkAboutXR2022-2464 - Permit ApplicationL . Print Foirm ] Worksheet for Combo Building & Solar Permit Application
Comm'I T,—g Residential City of Newport Beach - Building Division _�_ 2
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT *U1
F_ Building F_ Grading F—Drainage F_ Elec F Mech
Plum Cu Yd CutF
YdFill Cu F.
Project Address (Not mailing address) F_ Flood
f— Fire F_ Liq Landslide
F_N/A Floor
Suite No
SLI -3r-Ns Aucnue
......... ..... . . ...... .
.. . . .. .........
F_
Description of Work
M I
0 41
New/Add SFI.-7, Remodel SFI... Garage/New/AddF
J=irst
OWNER'S NAME Last 5-z 1 3 t I
Owner's Address
w-
City State C
Use Const Type F
# StoriesF # Units (if Res)F_
Valuation $ 0
Material/Labor
Owner's E-mail Address
ZIP Fcrtf I —()I Telephone 1_f_T;7_� i
APPLICANT'S NAME Lastl First - ------ I - ........ -.- ...... 11 1. - �... .. . ... ... .
Applicant's Address
City State
Applicant's E-mail Address
, 7
1 10 11.
Zip 4. 111(/ 0 Telephone D
ARCHITECT/DESIGNER'S NAME Last c /-I% Firstj Lic. No.
Architect/Designer's Address
. . ........
City C State FC -A
Architect/Designer's E-mail Address
Zip 10— Telephone 74/ 0 IL/
ENGINEER'S NAME Lasty 1 v First Lic. No.1,
Engineer's Address
City v State
FJ b
Engineer's E-mail Address
A.
Zip Telephone f`Le t - y12 -7?
CONTRACTOR'S NAME/COMPANY I 5Lic. No. Class RW61* T.
Contractor's Address
City Jprl V(cr.n t, . Oc G State FC
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
0—
Zip Telephone 1-7 2 T — 5-7 2 --7 5 2
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $
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