HomeMy WebLinkAboutPV2022-0298 - Permit Application (3)Print Form j Worksheet for Combo Building & Solar Permit Application 0�2EW'ORB
j— Comm'I r Residential
City of Newport Beach - Building Division
6:
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building r— Grading
r—Drainage [_ Elec r Mech j— Plum CuvdCut F CuvdFill F
Project Address (Not mailing address) I- Flood r Fire r Liq r— Landslide FN/A Floor Suite No
Description of Work
Use ConstType
PIC-J (/\(;;nV,
I 1
jv}cvc yr'rnl�Gt V, �• u Ki i
# Stories #Units (if Res)
Cor/\6!.1.e�r RC,x
New/AddSFF—
Remodel SFF— Garage/New/AddF—
Valuation $
Material/Labor oo
OWNER'S NAME
Last f �� First �,l
Owner's Address
Owner's E-mail Address
�C, Spi✓1 tir`v��
City
State F— Zip F— Telephoned
APPLICANT'S NAME
Last �J c, 50 First L-C) + } ✓ S
Applicant's Address
Applicant's E-mail Address
a0104 Si'atl?_
PA
City
State F Zip F Telephoned
ARCHITECT/DESIGNER'S NAME Last �— First F �—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State F— Zip F— TelephoneF_
ENGINEER'S NAME
Last � First F_ Lic. No.F—
Engineers Address
Engineer's E-mail Address
City
State F— Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY f . Lic No. y �l S Class ^ —�
V,rbo.v,er,erq J Sclfnli o
J
Contractor's Address
Contractor's E-mail Address
;�CIc)C Sf,,,t2 R�.
City
State F Zip F TelephoneF_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 1 Y 9i�72 _Vgq
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $