HomeMy WebLinkAboutXR2022-2031 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F Building Grading F-Drainage F7Elec F_Mech F-Plum cu Yd Cut Cu Yd Fill
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Address (Not mailing address) F_ Flood F_ Fire r Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use F_ ConstType F
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# StoriesF # Units (if Res)F_
Valuation$
Material/Labor FE,o06
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New/Add SF Remodel SF f Garage/New/Add
OWNER'S NAME Last f3eC,-_5 First �p(y✓�
Owner's Address Owner's E-mail Address
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City New cSi aeaC[� State I CA- Zip oiw63 Telephone F9y9-887-�SIQ
APPLICANT'S NAME Last ULfiM6 First rl�
Applicant's Address Applicant's E-mail Address
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City State F Zip Telephoner
ARCHITECT/DESIGNER'S NAME Last cCtn G First ��77
Arcchiiteectt/Designer's Address Architect/Designer's E-mail Address
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City 0Q,,JFo(+- State Fa�— Zip G`26C-�3 Telephone
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ENGINEER'S NAME P/,�- Last First Lic. No. F
Engineer's Address Engineer's E-mail Address
City State F_— Zip Telephoned
CONTRACTOR'S NAME/COMPANY �A ( my R2R� DeJ`1AcLic. No. 96712- Class
Contractor's Address Contractor's E-mail Address
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City State FcA__7- Zip TZ6rq Telephone G�cf9 R 52u
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. PC�(eSLZ , (cGJ(�7
USE ZONE �Zi��
DEVELOPMENT NO PLAN CHECK FEES $