HomeMy WebLinkAboutX2022-0716 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
F comm" Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X )DI- Q_7Jb
j41\Building rGrading Drainage r✓Elec �✓Mech Plum cuvdCuts cuvdrilis
Project Address (Not mailing address) F_ F_ Fire r Liq F_ Landslide F N/A Floor Suite No
�� LOC�4vJAt3r\- �C
Description of Work
Use k Const Type F
W�tQ s S�2ntNu R�MilIVJ1/
���CO
#Stories # Units (if Res)rs
Valuation $
Material/Labor '10��'
New/Add SFF 157— Remodel SFFVM
Garage/New/Add F
OWNER'S NAME Last iL�LQ�� MC
First cAA MS
Owner's Address
Owner's E-mail Address
LLLCc�\c®Vn.Ka\\•LO/
City ,7 State I W Zip Telephone C1 l ct 1,
APPLICANT'S NAME Last 1�/�LZ U�Jo k.
First r\y rj
Applicant's Address
Applicant's E-mail Address
SOL• U Y L1NCx1.
City State �—
Zip G1 `6 h] Telephone
ARCHITECT/DESIGNER'S NAME Last / First �— Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip F Telephones
ENGINEER'S NAME Last
First Lic. No.F —
Engineer's Address
Engineer's E-mail Address
City State �.--
Zip Telephone � �.•�
CONTRACTOR'S NAME/COMPANY nC
S Lic. No. 5ZS oy Class
�
Contractor's Address
Contractor's E-mail Address
t C ' Pt_� Qyi
O ^) ���� (j� • LU/�
City State
Zip G-LS Telephone
L
IZ1-3153
SETBACKS REAR SETBACKS FRONT
�t
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ? I �ti0�`
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $