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HomeMy WebLinkAboutXR2022-3243 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application F Comm'I F "Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F1'�uilding F_ Grading j—Drainage l— Elec Project Address (Not mailing addre: /o W2 C_�enaz Description of Work nqo S F r Mech Plum Cu Yd Cutl Cu Yd FN l F- Flood ( Fire F- Liq F Landslide FN/A Floor Suite No New/Add SF�— Remodel SF F— Garage/New/Add F-- Use r ConstType F # StoriesF_ # Units (if Res)F Valuation $ Material/Labor rf), lcz:�,' v rvnLn .l lYry1Y1C Last / cep / First are��a n Owner's Address Owner's E-mail Address /olP C�,,02 / City State (�— Zip C/1(o(o�i Telephone/5• 7/6•//Y7 APPLICANT'S NAME //� /J Last Li/"/? iS7�F LGf .ri auj�JisFirst. G Applicant's E-mail Address Applicant's Address - �'kl 9 _l//fit �I,oa /9f`lS-S rr2^ticce%%vrY Cl �n�c • co,>-� city J/gw . ��ge/� State � 92G63—Telephone9�f9 Y�G, o po© -- I � _ Zip ARCHITECT/DESIGNER'S NAME Last _ First �— Lic. No. �— Architect/Designer's Address ArchitecUDesigner's E-mail Address City State �— Zip F_ Telephone�— ENGINEER'SNAME Last First F� Lic. No.F� Engineer's Address Engineer's E-mail Address City State Zip F_ TelephoneF� CONTRACTOR'S NAME/COMPANY Lic. No. �"17s Ist�em a/� rs/ 9�/ S class d / Contractor's Address Contractor's E-mail Address /!/!c /ue% 3�(9 I/lil (tLl Dr Yf 5 �v fnccc • o,-, �y c City 4761(dPW bGkL/1 State �— ZIP 923 Telephone y Y9-Yc�•yy,, SETBACKS REAR SETBACKS FRONT PERMIT NO. �Ci ID I SETBACKS LEFT SETBACKS RIGHT �y Oc(J l PLAN CHECK NO. USE znNF