HomeMy WebLinkAboutX2022-0755 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o��`�Po e
Cityof Newport Beach - BuildingDivision
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Project Address (Not mailin/g� address) r- Flood F- Fire r4 Liq F - Landslide F_N/A F�loor� Suite No
Description of Work
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OWNER'S NAME Last / j2111111
First
Owner's Address
Owner's E-mail Address
City State �- Zip [_-___-_ TelephoneF_
APPLICANT'S NAME Last I �lZ-41"
First -)AIV
Applicant's Address
Applicant's E-mail Address
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Zip ", L e.Z Telephone �-7 -52 v4
ARCHITECT/DESIGNER'S NAME Last j 1?-AA.)jC,2% First F/Zf1 >✓. y Lic. No.
Architect/Designees Address
Architect/Designees E-mail Address
City w___,_.__T_----'"'-State T---
Zip--- TelephoneF—
ENGINEER'S NAME Last f .------
First F_ Lic. No.F-
Engineer's Address
Engineer's E-mail Address
City State �-
Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY
Lic. No. % 7q3 Class
Contractor's Address
Contractor's E-mail Address
City F State F—
Zip � Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. < 2vZZ -O7S S
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 0667 - ZGZ.Z
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ 25I % Z 3