HomeMy WebLinkAboutM2022-0051 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
[- Comm'] [- Residential City of Newport Beach - Building Division 4
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[—Building [- Grading (—Drainage [- Elec [-Mech
[- Plum CuydCut F CuvdFill
Project Address (Not mailing address) IW Flood
[- Fire F_ Liq [- Landslide [-N/A Floor Suite No
'*4e-7 FIN'LEy A-vENuf 5E
WALL [----
Description of Work TO ' M5�F- 7
4f
Use � ConstType
L /y/� },�/
��Q M 1Kt
D
# StoriesF_ # Units (if Res)[_
F
Valuation 5-
Material/Labor ,ZD�,DOG
New/Add SFIA0 Remodel SF1 P+ Garage/New/Add-
OWNER'S NAME Last M 1 CK01.
First F 014 Air_
Owner's Address
Owner's E-mail Address
3 07 PI&EY A �r-
clit)c ,zI I @ S o6c1,A6
City ��$ State FCC-
Zip 3 Telephone ��4 ' — I�7�.
APPLICANT'S NAME Last I Q � 6 AN
First
Applicant's Address
Applicant's E-mail Address
IState
Zip yet �Q GTelephone—d�� 3
&5;City
d
ARCHITECT/DESIGNER'S NAME Last First I Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F State
Zip �� TelephoneI�
ENGINEER'S NAME Last IF ✓
First �4ME;A V1 Lic No.�
Engineer's Address
Engineer's E-mail Address
21b(61 51TA5" c-'
CoNSULT!!�� @ FMA comet
City I `AG. N I! 6 u,5l. State l y l '
Zip 726 77 Telephone F(
CONTRACTOR'S NAME/COMPANY
Lic No. F ClassF
Contractor's Address
Contractor's E-mail Address
City � State F_
Zip F TelephoneF_
SETBACKS REAR SETBACKS FRONT
,
PERMIT NO. Y� (�!/ cKli
SETBACKS LEFT SETBACKS RIGHT �t ' �tl PLAN CHECK NO. 2OZ • Z1 I
USE ZONE DEVELOPMENT NO ✓ (fi P PLAN CHECK FEES $