HomeMy WebLinkAboutX2022-0432 - Permit ApplicationF'nnt Foam Worksheet for Combo Building & Solar Permit Application o��EWPOR�
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building [ Grading [Drainage ❑ Elec . [ Mech ( Plum CuYd cutF___J11 cued Fill
Project Address (Not mailing address) [ Flood [ Fire [ Liq Landslide [N/A ` Floor Suite No
00
Description of Work '
ConstTfti7..
# Stori # Units (if Res) .
New/Add SF=p Remodel SFGarage/New/Add
Valuatic
Material/Labors j CX�'
OWNER'S NAME Last d �f �,�iu® - - - - First 3
Owner's Address Owner's E-mail Address
City State GbG Zip °iZGb3 Telephonec,rGccY"
APPLICANT'S NAME Last First
Applicant's Address -
Applicant's E-mail Address
-
/®1--`+�\G°' a:. Olds ®.`� s�WK.i•J� Ct
City s, State ( j Zip" �- i Telephone47
ARCHITECT/DESIGNER'S NAME Last `ELL First Lic. No. C�t1o1
Architect/Designer's Address Architect/Designer's E-mail Address (ayr{e
�'• wl�N�t�E a�,.�.t� � 9��� � �e11� arc�ni-tee. :arn `�'
City t.i?-_- i State s Zip -�=� Telephone Zia-ago-gMz
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address _ Engineer's E-mail Address
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY 12�v Lic: No. i Class
Contractor's Address Contractor's E-mail Address
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City j- E Stste / t3o_ Zip L� Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO., G(2 <
USE ZONE DEVELOPMENT NO Pi AN rNFrk FFPc t