HomeMy WebLinkAboutX2022-1163 - Permit ApplicationPrint Farm I Worksheet for Combo Building & Solar Permit Application o4�EW�ae
Comm'I Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL -
r-Building I— Grading rDrainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) I— Flood r Fire I— Liq r Landslide I —N/A Floor Suite No
Description of Work
Use F ConstType F
# StoriesFT # Units (if Res)FT
Valuation $ _
Material/Labor 12I 2^
New/Add SF7T__ Remodel SF �7 F Garage/New/Add F__
OWNER'S NAME Last �+1eFirst
Owner's Address Owner's E-mail Address
1-73► Csvc�-�( Dom. c���,�is .`�-E-tee 1,•cort-�
City 4v� State C_'A Zip I r � Telephone q 1q ^ g— I (7y-
APPLICANT'S NAME Last First i 6 �>Q
••
Applicant's Address Applicant's E-mail Address
City �.� State F Zip F TelephoneF
ARCHITECT/DESIGNER'S NAME Last First Lic. No. L 4' J
Architect/Designer's Address Architect/Designer's E-mail Address
city State Zip Telephone 7 t'-- _709 - 7_-13c-
ENGINEER'S NAME Last
� t First '�j�uc__n ftIV&) Lic. No. � L}32s
I
Engineer's Address Engineer's E-mail Address
City State I Zip (%{Z6(�(p(Q TelephoneF'' (i t—Cjq-7-91Z0
CONTRACTOR'S NAME/COMPANY /�.. ��}_ „�iLic. No. '7���gClassW
Contractor's Address Contractor's E-mail Address
-{��{`�Y1S`fYL�G-i-IQ'1lu�G� �YY�I,i 1 •�1"�
City State I aif Zip q -Z(�p Telephone l fC—[PVL0-12_a4
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. I OZy
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $