HomeMy WebLinkAboutX2022-0142 - Permit ApplicationPrint Foam Worksheet for Combo Building & Solar Permit Application 091
F Comm'I r Residential City of Newport Beach - Building Divisionf �a`at{2NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �` P VI
Cp7Building i-Grading rDrainage Ftiec F,'16�ech �jMlum Cu Yd CutF- Cu Yd Fill[_
Project Address (Not mailing address) C Flood [ Fire i— Liq (— Landslide (-N/A Floor Suite No
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Description of Work
Use R, Const Type :V
# Stories #Units (if Res)
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Valuation S
New/Add SFFRemodel SF Gara a/New/Add —
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Material/Labor"
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OWNER'S NAME Last Ql/w/%l$'T First µtG
Owner's Address Owner's E-mail Address
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City 1,F mzT Efsw State FF�C_ Zip 92ai riO'W Telephone _2
APPLICANT'S NAME Last— First
Applicant's Address Applicant's E-mail Address
City State (�A Zip y12%�l0 Telephone C7/se)75i--1�1�/
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ARCHITECT/DESIGNER'S NAME Last First E�gq�� , Lic. No. ./f3-rfgff
Architect/Designer's Address Architect/Designees E-mail Address 6 B%
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City �y �'/�/ State Zip Telephone �j�,7, q9�7
ENGINEER'S NAME Last Lic.,j5 . ,2 ytd 3
Engineer's Address Engineer's E-mail Address
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City v*LGState l ;' Zip �47_2- Telephone V jF)Tp/—/�3a-c
CONTRACTOR'S NAME/COMP/ANY 4AA e-vA1,srQ4,,c7-1ov Lic.No. Jp'LV]W Class
Contractor's Address Contractor's E-mail Address
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City �5�rlf� /�/LL State ell* Zip � Telephone jLy'Ly4fi^Q22
SETBACKS REAR ,j?/,8// SETBACKS FRONT �/ „ PERMIT NO. g�)—CZ 7
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SETBACKS LEFT 3 /^ t? /� SETBACKS RIGHT 3PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 4 Z 'S