HomeMy WebLinkAboutX2022-1531 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'] i- Residential
NOTE:
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(-Building I- Grading j-Drainage F Elec F-Mech
Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) I` Flood
r Fire F- Liq j Landslide I N/A Floor Suite No
Description of Work
Use ConstType �—
# Stories # Units (if Res)l
r J !
Valuation
Material/Labor
Garage/New/Add
New/AddSFF Remodel SF�—
OWNER'S NAME Last 9406A ti�,;ivgo2.T GRA'_-S.-% First 1
Owner's Address
Owner's E-mail Address
abl �ni:cz.:�t� S-r
i
Ctty !! State
ZiP! Q 3 Telephone 94q 63 t 4
APPLICANTS NAME Last i314
First �CstJS
Applicants Address
Applicants E-mail Address
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NC-tyt.CTIi�
City- (1N I� State `"(�
[��
Zip 9 7--70S Telephone ;�/jl' �q 1 19I
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
ArchitectrDesigner's E-mail Address
City I State �—
Zip �— Telephone
ENGINEER'S NAME Last! (� Q
First Lic. No. 5 �- -
Engineer's Address
Engineer's E-mail Address
�p Q2o b K 1w u_ Dw/, 94 1 Lr
city _�ANV,� �N State �}
Zip Q1-:7p�- Telephone; � I(1 � �S �()
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CONTRACTOR'SNAME(COMPANY i �A�>✓S MLTI NSl Lic. No. 1617(+40 Classi Q
Contractor's Address
Contractor's E-mail Address
City S(�1�7T� 1`t(V �- State i�
Zip'q��&5 Telephone °'7l 4 S 3� � 19
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $