HomeMy WebLinkAboutXC2022-1994 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ���WPpRT
j� Comm'I F" Residential City of Newport Beach -Building DivisionC�22'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building f— Grading F—Drainage F_ Elec (` Mech F— Plum Cu Yd Cut F_
Cu Yd Fill
Project Address (Not mailing address) f- Flood r" Fire j- Liq F_ Landslide FN/A Floor Suite No
F-4�� _ OLD NE.W P b RX BL.VD F-
.... . .....
Description of Work AT p90i L p i Q/_ : Use
`�- Const Type
ROOF KEPAIRZ NEvJ E.LU ► Ri«L fma_ 1) mo Of a�AI�E
# Stories[ # Units (if Res)[ —
Valuation $
New/Add SF b Remodel SF�6 Garage/New/Add jar ,a Material/Labor 3�`&b
OWNER'S NAME Last TA�� First U�
Owner's Address
L_4lnly bL.� N E.W PDR_T-
City �,j EW PD1ZT Eh CV- State FCA
Owner's E-mail Address
RaRITI>:5AcE�.�.. MF-T
Zip TelephoneTw� 6(19 tor�
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
5TAMP5i STAMP _�M FA,,1}Z\JtEuJ AV E-
City 66l?T PASAX, V� A State R/A Zip q� n Telephone 3 ?)24
ARCHITECT/DESIGNER'S NAME Last M`�e,�5 First LA/� U
_ ZE�_ Lic. No.
rch itect/Desig ner's Address Architect/Designer's E-mail Address
Af �S S-rAtU53t0 FAIR�.I.EW. LA()RELi✓�,5[� Y IHCY� Cats .
City DU TH SADEN A --. State I.._ ...__ Zip l �D Telephone
ENGINEER'S NAME Last 7 First Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip �— Telephone
CONTRACTOR'S NAME/COMPANY rp �D St�ATE1Z. 50 CAL. Lic No ��2 ((� Class J3 C D
9F_K0DEuN(� PIK00L�
Contractor's Address Contractor's E-mail Address
52730 E.K-'f E.ND AvENU1EE.. 'SL.ATt&vn7�G�MA1L• COL`'j
C�-lt C
City State Z Zip 9r� 71 v�— Telephoneo�
SETBACKS REAR SETBACKS FRONT PERMIT NO. X CUZ.Z- �—�7Zqq
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2 Z L1
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $