HomeMy WebLinkAboutXR2022-2715 - Permit ApplicationL Print Form _ Worksbeet for Combo Building & Solar Permit Application �E °R>
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE; PLAN CHECK FEES DUE AT TIME OF: CI IRNnrrrnl
F_Building F_Grading j—Drainage j—Elec F Mech F_Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f Flood F_ Fire F_ Liq [_ Landslide F_N/A Floor Suite No
Description of Work
Use F—Const Type F_
#Stories #Units (if Res)
New/Add SF Remodel SF �Garage/New/Add F—
Valuation $ Fi
Material/Laborc
OWNER'S NAME Last �j-� First
Owner's Address Owner's E-mail Address
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City rv. k �z \� State CW Zip Telephone�—
APPLICANT'S NAME Last 4AA011d ._ First 1a..51�
Applicant's Address Applicant's E-mail Address
City State cl,F Zip Ct ? [o t c Telephone � q "t -3,S-6 6Zr
ARCHITECT/DESIGNER'S NAME LastFirst E�11r_, r
S Lic. No. I
A(�r�chitect/Designer's Address Architect/Designer's E-mail Address
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City CoSIw_J� S V State e Zip F2(, zG Telephone It�'iS Cl-LIDZ{U
ENGINEER'S NAME Last First F—Lic. No.F
Engineer's Address Engineer's E-mail Address
City State Zip TelephoneF___�—
CONTRACTORS NAME/COMPANY �� So.� C s�z vti ` u VVS Lic No. SOZ31� } Class
Contractor's Address Contractor's E-mail Address
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city ��ca Qc; ,)r c ti State C �- Zip 9 Z (Q Telephone®
SETBACKS REAR SETBACKS FRONT PERLIAP Q-y'i , Z-7 (�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 1kz1T 1_ 2
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $