HomeMy WebLinkAboutXR2022-2800 - Permit ApplicationL Print Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I Residential City of Newport Beach - Building Division
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Projectl
Address (Not mailing address) (7 Flood F Fire f Liq F_ Landslide FN/A Floor Suite No
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Description of Work
Use ConstTypeF
60 r7L�-
#Stories#Units (if Res)F
New/Add SF�— Remodel SF Garage/New/Add �—
Valuation $ 1 /
Material/Labor
OWNER'S NAME Last � First
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Owner's Address
/�� Owner's E-mail Address
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City Y� State Zip RI&Telephone
APPLICANT'S NAME Last FirstFj
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Applicant's Address Applicant's E-mail Address
City State 11
'\fin. � r }� Zip g271J�{ Telephone �Z t�l 7155t-L-07061
ARCHITECT/DESIGNER'S NAME
Last h, , q� First Ml-o Lic. No. �—
Architect Designer's Address Architect/Designer's E-mail Address
City /�
S4ni � �Chr� State Zip CLZZ0 Telephone C-1(l,ll ) igtq O�
ENGINEER'S NAME Last 1' First
�QJ�LCiti'+�. �' Lic. No. � � (o
Engineer's Address Engineer's E-mail Address
City State I— Zip F— Telephone—
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CONTRACTOR'S NAME/COMPANY �? Lic No. a 2 Class 3
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Contractor's Address Contractor's E-mail Address
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City (� � i f\, fl yv - State I 13� tTc Zip RZ70t TelephoneF�
SETBACKS REAR SETBACKS FRONT PERMIT NO. XOe0e22- ZBQ.j
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $