HomeMy WebLinkAboutXR2022-2899 - Permit ApplicationPrint Form IWorksheet for Combo Building-& Solar Poem--itf Comm'] Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Buwldln `oJ
g � Grading j'Drainage ec
Ntechlum Cu Yd CutF Cu Yd Fill
Project Address (Not mailing address) f7 Flood [ Fire j Liq Landslide [N/A (((
Floor Suite No
Po r, rTi oe 1- -
PLC
Description of Work
Use F Const Type F7
# StoriesF7 # Units (if Res)F7
New/Add SF�- Remodel SF j Valuation
- � Garage/New/Add Material/Labor
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OWNER'S NAME
Last
-- - - ---- -- -- - First �l e
Owner's Address -_--------------------_.. _
Z Owner's E-mail Address
_
City
c2�_ e1no State APPLICANT'S NAME -
Last
- ZIP 2G60 Telephone ?V7 Z 97_32
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Last J
��� ( First (J�rr
Applicant's Address - --_. ___ _. _..
C O si Applicant's E-mail Address
nt�baka Id c
City wrar (oat
State C� . Zip---- --- - .
_ - - (p � 7�� Telephone
ARCHITECT/DESIGNER'S NAME
Last � V Lic. No, r
-J hid I —
Architect/Designer's Address - First
Architect/Designers E-mail Address
City -� 4�ceT� 0.v� Coln C
i'S' i State _ Zi b — //'--- --- -- — /
--- P � 2 ��� Telephone / �� <3 g
ENGINEER'S NAME Last
First Lic. No.F—
Engineer's Address ---
Engineer's E-mail Address
city
State Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY
�Y1c irn� Cs�Vvct roti _�rr� Lic. No. �p2;2`Y%Class
Contractor's Address
Contractor's E-mail Address
94CC MQre�9C-1
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_9LNa r(y r Ca�
�
i� State �iq Zip �7706� Telephone 7/ --
SETBACKS REAR (b r SETBACKS FRONT
SETBACKS LEFT <T— —� SETBACKS RIGHT PERMIT NO.
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USE ZONE �G- DEVELOPMENT NO PLAN CHECK No.
PLAN CHECK FEES $