HomeMy WebLinkAboutX2022-1280 - Permit Application (3)_Print Fon-n I Wr,x)
sReet for Combo Building & Solar Permit Application
r Comm" r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Grading
Project Address (Not mailing
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of Work
A -\,ill
New/Add SFI o
OWNER'S NAME
Remodel SF
Mech
Cu Yd Cut
r Flood r Fire I- Liq r Landslide
Cu Yd Fill
FN/A Floor
Suite No
7 Use Const Type
# Stories # Units (if Res
-
-r
Valuation $
Material/La
Owner's Address Owner's E-mail Address
- - - - --- --- - -- R t o
City 7-1 4c1_ 11�Lr_ State F-C4 Zip `jcf,L Telephone `1
APPLICANT'S NAME Last
First j
Applicant's Address Applicant's E-mail Address
city F� :*7 car I-/fj,, State Zip'F Telephone i
ARCHITECT/DESIGNER'S NAME Last - First j Lic. No.
ArchitectlDesigner's Address- _
City % ., ri-2�- C, State C
ENGINEER'S NAME Last I
Engineer's Address
City State F
Architect/Designer's E-mail Address
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Zip ly 1 03 Telephone 2l `� �% I5'
First F_- Lic. No
Engineer's E-mail Address
Zip TelephoneF
CONTRACTOR'S NAME/COMPANY ISG`� `2 h Lic. No. ClassY
Contractor's Address
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City Cr/I o°w ca LPL /t /f PC State FA
SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
Zip Telephone 34/ . pe&
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PLAN CHECK NO. 1 IT K=
PLAN CHECK FEES $