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HomeMy WebLinkAboutPV2022-0214 - Permit ApplicationPrint Form Worksbeet for Combo Building & Solar Permit Application ��WPORT (� Comm'I s Residential City of Newport Beach - Building DivisionT %U NOTE: PLAN CHECK FEES DUE AT TIME OF SUB IA ov v �vj C�[iFO0.Nr F—Building [Grading Drainage Elec Mech Plum Cu Yd Cut Cu Yd Fill F Project Address (Not mailing address) [- Flood F_ Fire j7 Liq F_ Landslide 1-N/A Floor Suite No CA F_ F_ Description of Work Use � Const Type RVo- M©1A�� 5'G���v- pIJ �S N��� -,ov,\ �,o 4-Stories # Units (if Res)r Cap) I�cf M©�wl�� 2l G�-Prte� (l " �,' �nec Pc��2M� 1Jo N1PUi ... . ......... New/AddSFI _`�✓_._�oM RemodelSFs Garage/New/Add Valuation $ Material/Labor OWNER'S NAME Last ' � IVY\ i V��1 First Owner's Address _ Owner's E-mail Address City .. �v��or�'t'c71Ch_.. State Zip "UGU Telephone _ APPLICANT'S NAME Last Eo ) First Applicant's Address ..............._ .._ _. Applicant's E-mail Address City State F Zip Telephone ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip �— Telep hone. ENGINEER'S NAME Last r LApya First P�"' Lic. No, L� Engineer's Address Engineer's E-mail Address City ......_................ State Zip �— Telephones CONTRACTOR'S NAME/COMPANY (/Lr6ln Lv�C�Jc�lr Lic. No. �`��1�5 Class C-)0%+b J Contractor's Address Contractor's E-mail Address City (�('-fir; �-c�.� State C A Zip 90 703 Telephone v V t SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO ���� _ PLAN CHECK FEES $