HomeMy WebLinkAboutXR2022-2668 - Permit ApplicationLvint Forrn J Worksheet for Combo Building & Solar Permit Application U
F_ Comm'I (— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SIIRMITTAI �"—
j—Building F_ Grading (Drainage rElec F_Mech Plum Cu Yd Cut F_Cu Yd rill )
Project Address (Not mailing address) F_ Flood r Fire F_ Liq r Landslide FN/A Floor Suite No
F---
Description of Work
Use F Const Type
Stories #Units (if Res)
Lb
Valuation $
Material/Labor
New/Add SF�— Remodel SFF Garage/New/Add
OWNER'S NAME Last �QS14.1,First 1 3_1-1
Owner's Address Owner's E-mail Address
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City . QI/Lu/ v��'_�7(c(LL., State _ Zip 4FTelephone[
APPLICANT'S NAME Last 4n(� !\ p �.r,a First Y�
Applicant's Address Applicant's E-mail Address
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City a _ C�a C State Zip / �`� Telephone) yl / p� , 3 a o?
ARCHITECT/DESIGNER'S NAME Last (ran First/� r —
/ ! e—f )< Lic. No.F__
Architect/Designer's Address Architect/Designer's E-mail Address
City c l.State I` T Zip `�/ Telephone—
ENGINEER'S NAME Last L o ti� f h First rf7vs Lic. No.0 V 7?
Engineer's Address Engineer's E-mail Address
State F® Zip � Telephone7—
ONTRACTOR'S NAME/COMPANY Lic. No. f�J3D IV
OVA LCOnS�✓L �,,n St/U/Ca � �0 Class If 3
Contractor's Address Contractor's E-mail Address
?oss )t N. AON
City GA1vn` ��44A State Zip ,( / TelephoneF y IN
SETBACKS REAR SETBACKS FRONT PERMIT NO. r`
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 7 i 7 - �•j
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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