HomeMy WebLinkAboutXR2022-3329 - Permit ApplicationL �nnt Foam Worksheet for'Combo Building & Solar Petro' it Application o�aEWp°R@
j�f'Comm'I residential City of Newport Beach - Building Division z
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(;Building r Grading F—Drainage f— Elec j` Mech F— Plum Cu Yd Cut Cu Yd Fill
Project Aqdress (Not mailing address) J_ Flood F, Fire r— Liq F_ Landslide F_N/A Floor Suite No
,17 74
C�41�
Description of Work `�� /7lA
ltr'�fwyIr- !two / ��Ll�L' ✓ !�% ��'
New/Add SF jaa'rSdel SF
d� Use ��Const Type
if Storied # Units (if Res)
,4N Valuation $ -
2� S Garage/New/Add Material/Labor
l� C5,yl,5� /,f ,gU . i,,y
OWNER'S NAME --`-
Last�* ._ �/�Z{///Z/�.. C(9 First
_...............
Owner's Address Owner's E-mail Address
City State �— Zip Telephone��
APPLICANT'S NAME Last I / fJ X First J/j
y_
...___..._ ..... _.
Applicant's Address Applicant's E-mail Address
Ad
C
- - ...
City L^d.�. _. ( fi/l,'� State /� Zip �� (mil Telephone ... ._ 2 j_ ` �5
--`-
ARCHITECT/DESIGNER'S NAME Last— % First I�AXVI) l Lic. N
Architect/Designer's Address Arch itect/Designer's E-mail Address
City Sfiate— Zip Telephone
ENGINEER'S NAME Last First F Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip �— Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. a Class 11
Contractor's Address Contractor's E-mail Address J
City F—State F Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. ,11202- 332q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �xZitZ• ZD
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $