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HomeMy WebLinkAboutX2022-0412 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application r Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL FX Building r Grading r-Drainage (- Elec r Mech r Plum Cu rd CutF Cu Yd Fill Project Address (Not mailing address) F_ Flood j- Fire r Liq r Landslide FN/A Floor Suite No 263 WALNUT STREET I' Description of Work C21CIDn rt tO Use FSFR ConstType VB # Stories # Units (if Res)s CU YO Q ew 3.e L ew Valuation $ *0C)7 Material/Labor New/Add SF Remodel SF Gara a/New/Add 9 OWNER'S NAME Last MERZ First STEVE & ELAINE Owner's Address Owner's E-mail Address 263 WALNUT STREET City NEWPORT BEACH State CA Zip I Telephone APPLICANT'S NAME Last Richart First Jason Applicant's Address Applicant's E-mail Address 1041 W. 18th St, (A106) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address 1041 W. 18th St, (Al06) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ENGINEER'S NAME — Last GHAZLANI First ANDY Lic.Nof Engineer's Address Engineer's E-mail Address 1021 E. CARSON ST. STE #5 City LONG BEACH State CA Zip Telephone 562-253-2385 CONTRACTOR'SNAME/COMPANY I Lic.No.I ClassF— Contractor's Address Contractor's E-mail Address City State F_ Zip F— Telephones SETBACKS REAR SETBACKS FRONT PERMIT NO. , (�O�LZ--Gq I Z SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. IZ64 - Zug i USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 5 3 $ r 33 ru*v - 03to ,earz2- ar,9ri �'1i