HomeMy WebLinkAboutPV2022-0415 - Permit ApplicationPrint Form
_ .____ __j VVorksiaeet f®r Combo Building &Solar Permit Application AM—
r—Building
Comm'I r Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SU
r Grading rDrainage r Elec r Mech r Plum Cu Yd cut F
Cu Yd Fill
Project Address (Not mailing address) r Flood r Firer Liq r Landslide rN/A Floor Suite No
Description of Work
Use F Const Type r
j� # Storiesr— # Units (if Res)
New/Add SF�` Remodel SF�— Valuation $
Garage/New/Add �— Material/Labor
OWNER'S NAME Last //
S(X -1 First
Owner's Address
Owner's E-mail Address
1I ?fit 3t// �t lily
City i%L✓`t,'F rc4c4c State `<<
Zlp IL K TelephoneF
APPLICANT'S NAME Last �L/�.l'vt
- /' First
Applicant's Address Applicant's E-mail Address
City
? c State rc —
�i Zip CiG Telephone�—
ARCHITECT/DESIGNER'S NAME Last
First Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip �— Telephone
ENGINEER'S NAME Last First �®
Lic. No.
�—
Engineer's Address Engineer's E-mail Address
City State �® Zip i Telephoned 4 1 CONTRACTOR'S NAME/COMPANY /
T 1
Lic. No. (v Yf j Class
Contractor's Address / Contractor's E-mail Address
City r r I� State L�— Zip ! ) ;7 Telephone II(� Z r,L?
SETBACKS REAR SETBACKS FRONT PERMIT NO. 177,022 - oq
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_. .... ..._... PLAN CHECK NO. f-LZQZJ�_SB Ld
ISE ZONE nFVFI nPRAPKiT Kin _