HomeMy WebLinkAboutXR2022-2301 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm'I j' Residential City of Newport Beach - Building Division / yn `�
NOTE: PLAN CHECK FEES DUE AT TIME OF SIIRMIrTAI
WP
�s
Tm
X6uilding [_ Grading F-Drainage Elec xMech `Plum Cu vd Cut Cu Yd Fill l
Project Address (Not mailing a//ddress) F_ Flood r Fire f— Liq F_ Landslide I -N/A Floor Suite No
Description of Work
Use I— ConstType F_
c 1-vi� v✓I � l7�rlw y lr
# Stories # Units (if Res)F—
n /l L
.,VG_vt _lV-i51 Q�
N b$m�-
New/Add SF Remodel SFGarage/New/Add
Valuation $
Material/Labor / D
OWNER'S NAME Last L' f
ent I. (/ First
Owner's Address
Owner's E-mail Address
City p}� r,C (�?� State ZIP�— Telephone 55.E
APPLICANT'S NAME Last lyi iZY�C.+ h First
_
Applicant's Address Applicant's E-mail Address
11r Z J.s
City ��GG, .{ K u State F-7-Zip Telephone i ym -
ARCHITECT/DESIGNER'S NAME Last First—Lic. No.—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip Telephone
ENIGINEER'S NAME Last First Lic. No.
Engineers Address Engineer's E-mail Address
-
City State Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY ; CO f3c.i I &Vj r CC,, 9%, 6 (1 0 Lic. No. 79 33 lC Class
Contractor's Address Contractor's E-mail Address
W (� �LL � iNroC��lU.'=X�'i IdP) CC, w�
City .�rj 1� (Mf'SGi State CA Zip ��� G) T Telephone bid Lei - 31�t
SETBACKS REAR SETBACKS FRONT PERMIT NO. x �o22� Z. 3 0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $