HomeMy WebLinkAboutX2022-0573 - Permit ApplicationL F=rintForm _ J Worlkatuedt for COmbo Building & Solar Permit Application (1-04A
f Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHFCK FFFS Ill IF oT TIAAC nr ci io KAITT A,
F—Building j—ZGrading F—Drainage j-Elec FMach F—plumCu Yd cut Cu Yd Fill `Y
Project Address (Not mailing address) F7 Flood F_ Fire F_ Liq F_ Landslide F—N/A Floor Suite No
Dove. cc, cv,
Description of Work
Use F ConstType
# Stories # Units (if Res)F7
�Pw�e�-•.1 cf (or��"avr��+,1u
�e � p;r � 2' l 51� ��e
New/Add Sr� — Remodel SF�_—
Garage/New/Add
Valuation $ u
Material/Labor
OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
2. iV�w_io�f _Ce ofe.0
City I�1 W �i!__CtAI.F!1_ State zip y 2 G �, Telephone �l�i _ Cis-]
APPLICANT'S NAME Last p
l f`�2L First 50 SS �-
Applicant's Address Applicants E-mail Address
- - _.JPcreZ I��i rt
City �w r t i 4 t State ----
G� �0.Ch (� Zip
�zb�� - Telephone l:6 215(l 2k
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 F ®
Lic. No. F
Engineer's Address Engineer's E-mail Address
City I State l� Zip �— Tele honeF
CONTRACTOR'S NAME/COMPANY r/ R (Z /
uN,�1edf�<t Lic. No �95iV Class
Contractor's Address Contractor's E-mail Address
( J fi�tre ZL I ClG 1rwd�v� q .
City �1Un Yt�tC• 1 State C Zip l 2 l 1 Telephone l Ji
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $