HomeMy WebLinkAboutPV2022-0223 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Appilealiionv23
City of Newport Beach - Building Division I
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood F- Fire ("- Liq F- Landslide I_N/A Floor
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Description of Work
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New/Add SFF—
OWNER'S NAME
41 mcdales 0 / m c ea inve%I0,1(S
Remodel SF F— Garage/New/Add F_
Suite No
Use F_ Const Type
# Stories #Units (if Res)
Valuation $
Material/Labor
Last Qecke First re1C �
Owner's Address Owner's E-mail Address
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City hewraa V Ach State /q Zip L�2(pi/D Telephone (pIq-YN7'S18(
APPLICANT'S NAME Last I V, eAs
Applicant's Address
City State r�k
First
Applicant's E-mail Address
Zip 6t'4Jy2 1 Telephone g
ARCHITECT/DESIGNER'S NAME Last First Lic. No.�
Architect/Designer's Address Arch itect/Designer's E-mail Address
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City State F Zip [
ENGINEER'S NAME Last First F__ ______— � Lic. No f
Engineer's Address Engineer's E-mail Address
City State F Zip F Telephone[
CONTRACTOR'S NAME/COMPANY I
L ` �i�� Lic. No. gg6gzo Class L' Li (a
Contractor's Address Contractor's E-mail Address
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CityeGj State c A Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. ZoZZ• 02Z3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $