HomeMy WebLinkAboutXR2022-2139 - Permit ApplicationPrint Form_ _ I Worksheet for Combo Building & Solar Permit Application 000'6
Comm'I City of Newport Beach - Building Division(— Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(Building rGrading r—Drainage F_Elec F_Mech F—Plum Cu vd CutF_ Cu Yd FillF_
Project Address (Not mailing address) i— Flood r Fire i— Liq I— Landslide F_N/A Floor Suite No
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Description of Work
Use F Const Type
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# Stories #Units (if Res)
Valuation $
Material/Labor
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New/AddSF� Remodel SF�— Garag e/t�v/Add,—
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OWNER'S NAME Last rll� First —Tha,�
Owner's Address
Owner's E-mail Address
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City State r��'ttt
_l_FJfQf'XJL. Gib VF Zip F— Telephoned--
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address "1
City State �— Zip i— Telephoned
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ARCHITECT/DESIGNER'S NAME Last Firs—
_ Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F— Zip � Telephoned
ENGINEER'S NAME Last 0mp�;ON First f �� 04 t Lic. No, I
V
Engineers Address Engineer's E-mail Address
JUI i .'rtugf(i 1 Ave
Ave
City 7 Ii t(N�p�I� State Zip Telephone 71y _6100
CONTRACTOR'S NAME/COMPANY / Lic. No. Q// Class C 77
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C59
Contractor's Address Contractor's E-mail Address
City yar4q arm State C� ' Zip II z701 Telephone 711 f2 �6J
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SETBACKS REAR SETBACKS FRONT PERMIT NO. [L. ] {J �—)O 7 5'
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NOt
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $