HomeMy WebLinkAboutXR2022-3278 - Permit ApplicationI- PrintForm_J Worksheet for Combo Building & Solar Permit Application NEWPoRr
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C-Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL RYZ 1U as '�17
A78uilding Grading F-Drainage j-Elec F_Mech r Plum Cu vd CutF_ Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire r Liq F_ Landslide F_N/A Floor Suite No
Description of Work "rj/Z—,r
Use %L—cConstType `/ j?
#Stories # Units (if Res)F27
/r ZO,4 Z11 S A 40 ��i 6141_- � � � � // � �� � 4;, <
5ii n °
New/Add SF�— e SF /Z/ c� f
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Garage/New/Add �—
Valuation$/ /y �'�
Material/Labor /Gi Cy-2,
OWNER'S NAME Last 1/7-�/lX/j (e,?First
Owner's Address
Owner's E-mail Address
City ��li� _-- State
Zip Telephone�—
APPLICANT'S NAME Last -7z- ///Q
First Jt \�
Applicant's Address
J
Applicant's E-mail Address
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A'/ ce
City /J J L%'�Ud 6/41NY� State
Zip Z Z Telephone y % — Z,,� ,;
ARCHITECT/DESIGNER'S NAME Last /f/First /A/V/)'
(` G y Lic No - 2¢ Z�S
Architect/Designer's Address
Architect/Designer's E-mail Address
City SlabilZip
Telephone—
ENGINEER'S NAME Las
F' Ly�jR u
Engineer's Address
Engineer E-mail Address I/ V 1�L f/��
City State
Zip �— Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. F— Class
Contractor's Address
Contractor's E-mail Address
City State F_
Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO, Y�Qyj • 3Z7$
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Q�y,yZ �31 GJ(
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $