HomeMy WebLinkAboutX2022-1255 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4Y",a
F_ Comm'I IX Residential City of Newport Beach - Building Division � .
OTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL /���'�'� N.
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Project Address (N ailing address) Flood Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work t �R �S
Use F— ConstType
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#Stories #Units (if Res)
Valuation
Material/Labor
New/Add SF F- Remodel SF � Garage/New/Add
OWNER'S NAME Last I CEC_CV i j I First ;'Of}tl ORR NAt4C-y
Owner's Address Owner's E-mail Address
City 4 OfZoAAL tj?,(✓ State C—f - Zip � IJV 2S Telephone 4kr309
APPLICANT'S NAME Last �j0(AG�( First ,7 C-jtZG
Applicant's Address Applicant's E-mail Address
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City 5A-KI MH CoS State FCWV Zip I W Telephone (ply);_7p1' l l 1p(o
ARCHITECT/DESIGNER'S NAME .. I �(S 14� /- ! 2
Last VV r p First L! � 1p Lic. No. J
Architect/Designer's Address Architect/Designer's E-mail Address
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City State F_ Zip F_ Telephoned
ENGINEER'S NAME Last First F_ Lic. No.F_
Engineer's Address Engineer's E-mail Address
City F— State F_ Zip F Telephoned-1
CONTRACTOR'S NAME/COMPANY WES-fetzrl j7VGip,s I ((JG . Lic. No. Class �',!Z
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Contractor's Address Contractors E-mail Address
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City I sA-A MAVCO.S' State I b Zip Telephone &O- :7-"-??111f
SETBACKS REAR t SETBACKS FRONT �S t PERMIT NO. . \ L,
SETBACKS LEFT I SETBACKS RIGHT PLAN CHECK NO. I %
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $