HomeMy WebLinkAboutXC2022-1983 - Permit ApplicationPrinIF cirm, Worksheet for Combo Building & Solar Permit Application saw
Comm'I ElResidential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIMF OFAI IRMirrcl
KBuilding Grading []Drainage KElec Mech Plum cuvdCutF CuYdFill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq [ Landslide ❑N/A Floor - Suite No
7�
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Description of Work p� Use
��'f� onstType l_ '
8 StoriesIm N Units (if Res)E]
Valuation $ /
New/Add SFRemodel SF L Garage/New/Add �] Material/Labor
OWNER'S NAME Last=_��r�i �First ----- ---- J J
Owners Address Owner's E-mail Address
City �/n/� State A Zip L Telephone - 71> U
APPLICANT'S NAME Last yI First
Applicant's Address Applicant's E-mail Address
City State Lq Zip ( 77 Telephone Z• _-�tj Yp
ARCHITECT/DESIGNER'S NAME f f�
Last �� (f�17 _ J Flrst 554 Lic. No. GTq
ArchitecUDesignees Address Architect/Designer's E-mail Address
U�5— i f� Kf�4uR U�• —I i
City (✓tN 0!✓ - ����__--_1 State FT -- - Zip F
7Z b_D Telephone if..1 G,
ENGINEER'S NAME Last _ _ - -- - First i Lic. No.F_
Engineer's Address Engineers E-mail Address
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City --_-.- --_- State ZIP �i Telephone
F—
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractors E-mail Address
City State Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. >�CZp2Z- 1 0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. P -02L
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $