HomeMy WebLinkAboutXC2022-2033 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
Comm'l ❑ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALKG1 0-4-1 - a )33
Building ❑ Grading CDrainage ❑ Elec
Address
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of Work
0 Mech ❑ Plum cu vd cut] I cu Yd Fill
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Suite No
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Valuation $
New/Add SF � ,I Remodel SF I Garage/New/Add MatedaULabor
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OWNER'S NAME Last
Owner's Address r - I
Owner's E-mail Address
CRY — — ( State I C ZIP � Telephone q `�4r#
APPLICANT'S NAME Last I '1 A!" I 1 First
Applicant's Address - Applicant's E-mail Address
City � � _ j State Zip Z (Z7i Telephone I --li7 4,>0
ARCHITECT/DESIGNER'S NAME
Last��J�lyJ�f7 --I First �j�,(,(� _ Lic. No.
ArchitecUDesignees Address 11 Architect/Designer's E-mail Address
City I State r/ 1 Zip 2Telephone ell �,
ENGINEER'S NAME
Last _ _ - — -� First Lic No.0
Engineer's Address Engineer's E-mail Address
I I
cityIState Zip Telephone
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CONTRACTOR'S NAME/COMPANY Lic No.
69zy71 Class--3-11
Contractor's Address Contractor's E-mail Address
City _ __- State ��' 2i Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO. xL — LC2
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. C Z67i v Z
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $