HomeMy WebLinkAboutX2022-1538 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application lz
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Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading rDrainage ( Elec j-Mech Plum Cu vd cutI Cu Yd Fill
Project Address (Not mailing address) Flood - Fire j- Liq Landslide I N/A Floor Suite No
_ (ACC Q N RC
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Description of Work
Use [— Const Type jr—
# Stories, 1 # Units Cif Res)
n
Valuation $
Material/Labor 12,000
New/Add SF�- Remodel SF;
Garage/New/Add i
OWNERS NAME Last �y} y� W (JD^� C,r(„� �� First j
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Owner's Address 14O F,
Owner's E-mail Address
`Lol Tlil�tt:�PiD S
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city _ R State CA
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Zip 1f� Telephone'.949 61 y 0 `� 2.
l LFiirst �(:)i
APPLICANTS NAME Last, M i
i P✓C-US
Applicants Address
Applicant's E-mail Address
�016. rOV, ; t
City _ � (\ N State 1 C I_
Zip'Cj-1-7 S Telephone9 I LL � � I I rz�l
ARCHITECTlDESIGNER'S NAME Last
First! Lic. No. j
Architect(Designees Address
Architect(Designers E-mail Address
city State
Zip— Telephone--
ENGINEER'S NAME Last /� I (7
First j I py (3 Lic. No.! _Sa to 1
Engineer's Address
Engineer's E-mail Address
I S �...D �J•Lp0 ie-1-F Di.l.'pW , '� t �S
City 5 State G 114
Z7,p , q1,)l^tL) Telephones 114
CONTRACTOR'S NAME/COMPANY 3 C l)S S fw i i i k GO iU S�X- Lic. No. 637 p classFA
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Contractor's Address
Contractor's E-mail Address
l
�41
(n��,�t,, / n
City SRNT� _1iN State I (.4+
c�
Zrp'q����- Telephone, �Jb dI9I
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK N0.
PLAN CHECK FEES $