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HomeMy WebLinkAboutPV2022-148 - Permit Application�, arint Form Worksheet for Combo Building & Solar Permit Application I— Comm'I �.eesldentlal City of Newport Beach - Building Division ry i £ NOTE: PLAN CHECK FEES DUE AT TIME OF suaMITTAI �'�/ _.., Y,Quilding F_ Grading r"Drainage F_Elec F_ Mach FPlum cuYdcutF CuYdFill l Project Address (Not mailing address) 1- Flood r Fire [- Liq r Landslide FN/A Floor Suite No P,1. 04-0 Ave F F_ Description of Work Use F_ ConstType F_ ►V�I�/ S'aLt4rc ev zOC-F*t0Lttir_ ^ Z/yo # Stories #Units (if Res) - .. .. Valuation $ Material/Labor r New/Add SF Remodel SF Garage/New/Add �; OWNER'S NAME Last �1.N Nam. First Owner's Address Owners E-mail Address /3o a- _ /JA_R lCao'�_n 'gVFZ City i 1 q �( 1vFW - t— .. i State �%�}. � Zip 1 � Telephone '/.aL� � ���-^,-aaf-• � (- QEAC APPLICANT'S NAME Last ��?/1,1�W� First ��1 c 0&( Applicant's Address Applicant's E-mail Address 5/Mo,✓FIe©Z�tT/vAJs�A1fiP ocdth City (owije State ZipFqoF4j Tele hone ARCHITECT/DESIGNER'S NAME Last �— First �- Lic. No. F Architect/Designer's Address 9 Architect/Designer's E-mail Address ......... ..... : City State F Zip—�i Telephonel � ENGINEER'S NAME Last �— First F Lic. No.' Engineer's Address Engineer's E-mail Address City �— State r Zip �— Telephoned CONTRACTOR'S NAME/COMPANY Lic. No. Class 5-- �t/c�L.uTta� >�NE@G 1 `li1`/`Jr3,(s'� ��YE� Contractor's Address ContractorE-mail Address R1�2 FeFs N�_ 9 V G City �oln)( t(� State c-' Zip F qdQ-gl Telephony T *-8 to SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 40i USE ZONE DEVELOPMENT NO PLAN CHECK FEES $