HomeMy WebLinkAboutX2022-0878 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o�EW%m
Comm'( Residential sion
NOTE: PiLAN CHECK FEES DUE AT Tty of Newport Beach - IME OFng (SUBMITTAL Qa- -o V
`Building ry Grading F-Drainage FElec F_Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing
address) F_ Flood r Fire F_ Liq r Landslide i-N/A Floor Suite No
Description of Work
Use ConstType
# Stories #Units (if Res)
New/Add SF Remodel SF 2 s v
Gara a/New/Add
g F_
Valuation $
Material/Labor160/006
OWNER'S NAME Last
fAu•d S
First pc t1
Owner's Address
Owner's E-mail Address
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UD Ct'�ASIS��U'. C-o—
City ak-)(u•rk- ?ems r (
State C Zip (Z 1(C Telephone
APPLICANT'S NAME Last
First I IwS.,za u t
Applicant's Address
Applicant's E-mail Address
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City Go t i l,'
State I (/,
Zip 0,i)8` S Telephone S G 2 4 E J- ( 3
ARCHITECT/DESIGNER'S NAME
Last �� 7�� First lam✓ t Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
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��i.k I K�``UA�Aiw'c�,
City
State C.�
Zip Telephone I+-{ 5 c» Kj 3 3 j
ENGINEER'S NAME Last
First F Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip �— TelephoneF_
CONTRACTOR'SNAME/COMPANY
`
�U,�S u<{,ty.� Lic.No. 33Vi�S3 Class i5
Contractor's Address
Contractor's E-mail Address
City C (�G`�
State �-
Zip e j(S Telephonelj�Z-G1 - /p�
J
)( ZGZZ -p c
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. 07
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. (,(J "l-2U'LZ
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $ SC7-
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