HomeMy WebLinkAboutPV2022-0327 - Permit ApplicationPrint Form- _J Worksheet for Combo Building & Solar Permit Application
F Comm'I i Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI
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F-Building Grading F-Drainage F_Elec F_Mech Plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) 1- Flood F_ Fire F- Liq r Landslide F_N/A Floor Suite No
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Description of Work
Use F—Const Type
# Stories# Units (if Res)F
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New/Add SF�— Remodel SF� Garage/New/Add �—
Valuation $
Material/Labor
OWNER'S NAME Last . S QiQ h e q - First _ .. rA ✓ktJ,H U _
Owner's Address Owner's E-mail Address
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City (�i � � State FC-4 Zip q2 �o6, Telephone 1 F J Z z� �.. % 1 C C
APPLICANT'S NAME LastFirst ��� `( •V
Applicant's Address Applicant's E-mail Address
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City ,u 57 State C�- Zip — Telephone S(OZ-)_ ` 0- IS-L
ARCHITECT/DESIGNER'S NA E Last Firs Lic. No. F—
Architect/Designer's Address Architect/Designer's E- it Address
City State F Zip �— TelephoneF—
ENGINEER'S NAME Last Vkf*f Fir Lic. No.F—
Engineer's Address Engineer's E-mail AdAss
City State Zip TelephoneF—
CONTRACTOR'S NAME/COMPANY 'T;7CC'V{ UClass Gy
Contractor's Address Contractor's E-mail Address
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City Gcv ll State (� ZiP ' Z Pj01 �) Telephone ,�G-(` -2,40 -) S'Zq
SETBACKS REAR SETBACKS FRONT PERMIT NO. �
SETBACKSLEFT SETBACKS RIGHT PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FELSS
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