HomeMy WebLinkAboutX2022-0328 - Permit ApplicationPnrt Form:_ poR
Worksheet for Combo Building'& Solar Permit Application o4 NEWe
City of Newport Beach - Building Division0.39
[� Comm'I ❑Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL vk
?Building F, Grading [Drainage ❑ Elec F- Mech F Plum Cu Yd cutCu Yd Fill
F_j'
F71
Project Address.(Not mailing address) FFlood C Fire FI Liq [Landslide N/A` Floor Suite No
J.
Description of Work '
i Use ConstType. � �}
# StoriesFj #Units (if Res} i
Valuation $ 5 ar New/Add SF C/% Remodel SF Garage/New/Add �i� -� Material/Labor
OWNER'S NAME Last ii� First tit
Owner's Address Owner's E-mail Address
City �� ? `�UJ` .iljcticU State e. _ Zip c_� Telephone
APPLICANT'S NAME Last , First
L) f k� �._
Applicant's Address Applicant's E-mail Address
city fi f� �Ua'� cc � State LY• t- Zip 1/7 Q_j Telephone (P Y4..722-1Y
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address -
City State �� Zip Telephoned
ENGINEER'S NAME I Lic. No
Last Al l First � � ��/� c.:� l: �Z U Y�� � � �� � M.2-'7V_�I
Engineer's Address, Engineer's E-mail Address.
P P Ci State Zip Telephone
ty _
CONTRACTORS NAME/COMPANY Lic. No. L ClassIVPI
C
Contractor's Address Contra or's E-mail Address
i
L ( pia t� v L�
7ukaa---- =
city StateZi V� �� Thone L�'v ' � P ele -C� 1 . J� P
SETBACKS REAR SETBACKS FRONT PERMIT NO. !\ 20 Z �'G3 Z 91.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. G 2 7- 207 Z
USE ZONE DEVELOPMENT NO p2UZ l _ fiG 37 PLAN CHECK FEES $