HomeMy WebLinkAboutX2022-1253 - Permit ApplicationPrint Form
Comm'I F
Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFR nl IF AT TIRAP nG si IPRAI rAi
IV Building F Grading F-Drainage [Elec F_Mech plum Cu Yd Cutl Cu Yd Fill F_
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq r Landslide [-N/A Floor Suite No
Description of Work
Use F7 ConstType
CW DO - � G u c -"
# StoriesF- # Units (if Res)
styp Remodel SF�— Valuation
New/Add SF
Garage/New/Add � Material/Laa
bor
OWNER'S NAME Last
/�0p �� �� First ff
Owner's Address Owner's E-mail Address
G,z 1.--
City n I -_ -
r"V Wit")jA State Zip yjo Z�' Telephone
APPLICANT'S NAME Last _ - First LI rl N ro
Applicant's Address Applicant's E-mail Address
City -
��La'�`�_ State ��- Zip z�.ZS- Telephone
ARCHITECT/DESIGNER'S NAME Last (�
First r Lic. No. C_ -z
7-
Architect/Designer's Address I. (� Architect/Designees E-mail Address
City J L tom- oti — State Cq Zip i Telephone
ENGINEER'S NAME Last / First 16 Lic. No.
Engineer's Address Engineer's E-mail Address
-
City-�C1U�Pr-------_ - State � � zipTelephone 7
CONTRACTOR'S NAME/COMPANY
�0 _K-Ctl: /-e=___Gc��`.�j_:, Lic. No._Ljp,u,7S Class �'•�
Contractor's Address Contractor's E-mail Address
City C State Zi n F rT 1' Q
P_I � (.0�1. Telephone _...--l-�i�.�...(`�Qq
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. )1U`1 20`LZ
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $