HomeMy WebLinkAboutX2022-1579 - Permit Applicationr ____NnntForm , Worksheet for Combo Building & Solar Permit Application
F Comm'I r— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not Mailing address) F_ Flood j— Fir
Description of Work
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OWNER'S NAME
Owner's Address
City
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Remodel SFI Z7 rc Garage/New/Add
Last I First F_ A I eZN
Owner's E-mail Address
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ZIP F� Tale
Suite No
Use F Const Type
# Storiesr— # Units (if Res)F
Valuation $
Material/Labor�iU
APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last - First Z, '
Architect/Designer's Address -
Architect/Designer's E-mail Address
City
State Zip Telephone—
ENGINEER'S NAME Last
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Engineer's Address F�T
Engineer's E-mail Address
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city
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CONTRACTOR'S NAME/COMPANY f
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Contractor's Address
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City 5i4 i.4 tH,v � — — State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
see V i C G 5 1 C Lic No. F7S_Z 70 Class I�
Contractors E-mail Address
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Zip �T- , IT—iephone `('4 Z�>' TZ.! i
PERMIT NO. �Zi24 2 _1{ '74
PLAN CHECK NO. Ir�P • ��22
PLAN CHECK FEES $ `1