HomeMy WebLinkAboutPV2022-0238 - Permit ApplicationPrint Form _ Worksheet for Combo Building & Solar Permit A I� Comm'I pplication o��EWaoR� Residential City of Newport Beach -Building Division V VZ� 22'0NOTE- PLAN CHECK FEES DUE AT SUBMAL ✓
F-Building (— Grading FDraina e c'` 0 111 �
g [ Elec F Mech Plum
Project Address (Not mailing address Floo Cu Yd Cut Cu Yd Fill r
�- d
L�rr ) r Fire j` Liq j- Landslide F_N/A Floor
/�q � C �`S v Suite No
escription of Work
..........-..
/Vevt-
Use Const Type
# Storiesr— # Units (if Res)F—
New/Add SF
Remodel SF Garage/New/Add �— Valuation $
Material/Labor
OWNER'S NAME l
Last
- First
Owner's Address
.... -._.. __..._. _....._....._.
Owner's E-mail Address
City
State
Zip
- Tele
--
APPLICANT'S NAME - --- . -__.__
pone
- -7
_.
Last n� )_ First C v,•l Gi,ei2ti!
Applicant's Address
Applicant's E-mail Address
City ®k-AA k
State— -
Zip
r Telephone p
i1
ARCHITECT/DESIGNER'S NAME �s3 7Z
Last
_
Architect/Designer's Address First ._........
Architect/Designer's E-mail Address
City
State --- .-__
_ _ Zip _
_
ENGINEER'S NAME
Last
Telephone
F77
77�
First
Engineer's Address F.Lic. No.
Engineer's E-mail Address
City
State
_ Zip ._ _ _.._
- Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. 9
Contractor's ' Address _ti _v Class
77 y / Contractor's E-mail Address
City (�i�ot
State � Zip
Telephone �cl/ ., b3Z '��Z3
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO. J �� ✓ 01 3 p
SETBACKS RIGHT
USE ZONE PLAN CHECK NO. 1 j
DEVELOPMENT NO V
PLAN CHECK FEES $