HomeMy WebLinkAboutX2022-1360 - Permit ApplicationPrint Form ,Worksheet for Combo Building & Solar Permit Application o2fWWR9
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building 'R,Grading [-Drainage r Elec I- Mech jj�
Plum Cu Yd Cut Cu Yd Fill
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Project Address (Not mailing address) F7 Flood [- Fire [- Liq Landslide rN/A Floor Suite No
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Description of Work
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Use s ConstT
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# Stories # Units (if Resf
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New/Add SFI Remodel SFF-
Valuation $ ��
Garage/New/Add F_ Material/La r
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OWNER'S NAME Last T�CDD-C
First arcy�
Owner's Address
Owner's E-mail Address
3.J DC? vOA 00/,V PC_-z
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City /v ISI_U(W"q7 j36_-ct4 State F2; - Zlp I��a6o Telephone 76ci c-//7 C d
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APPLICANT'S NAME Last ��U�
First
Applicant's Address
Applicant's E-mail Address
City State F—
-- ..
Zip f— Telephones--
ARCHITECT/DESIGNER'S NAME Last
First F_ Lic No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State I
Zip �— Telephoned—
ENGINEER'S NAME Last 2 U 1'Z.
First �`� x.t Lic. No. SS Z 7
Engineer's Address
Engineer's E-mail Address
GJLODo(Ci-4 S j
)1(9 2L �2T�NC�A�L��PiNb
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City ��T'/+V6 �U Q� State
7._ _..
Zip - �j2G�J.6 Telephone �/
CONTRACTOR'S NAME/COMPANY J � �C �u Lic No. t 8cW,5- Classr�
Contractor's Address
Contractor's E-mail Address
?031 S.
I Dppvt)e,t SC -7-/
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City 51'�r�Y-� a��--T-'t� State �/�
Zip `ic^cf" Telephone?/t/� 5,i %"-
SETBACKS REAR SETBACKS FRONT
PERMIT NO.`Ci
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Z - 22e
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $