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HomeMy WebLinkAboutX2022-0199 - Permit ApplicationX2022- Worksheet for Combo Building & Solar Permit Application r Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F -Building F- Grading rDrainage j— Elec Address (Not mailing W.Ae (-Mach F-PlumCu Yd Cut Cu Yd Fill F Flood r- Fire (- Liq F- Landslide r -N/A Floor Suite N( New/Add Use F— Const Type # Stories # Units (if Res)r Valuation $ Q ` Remodel SF 7 — Garage/New/Add i— Material/Labor V OWNER'S NAME Last �V I, C, yST- Firsti Owner's Address p Owner's E-mail Address `1D� -1:nt�Z�1?I o ST City ... State i G _ Zip FTU61Telephonel'94'T n -m APPLICANTS NAME Last I sth t -vk First I IAN &W Applicants Address A I' Y E 1 Address l` .7-1,4`L CP'tjWD1\/ \ City ARCHITECT/DESIGNER'S NAME Last Architect/Designees Address city' p(p�scan s -mal y tev State I� Zip 9).? ©s Telephone �71 � g f cr, First Lic. No. 7— Architect[Designers E-mail Address State �— Zip F— TelephoneF— ENGINEER'S NAME Last l Xi AQ Engineers Address j S�'L.0 QYZoO`& vk oNa-10,iAI ItS City �tnfit� R1Tv . -- State i FirstLY - � Lic. No. � Engineer's E-mail Address /' Zip I 7 (7S Telephone 7 J4 6G Z C)_5-10 CONTRACTOR'S NAME/COMPANY Contractors Address city.'. tv- .. State SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO Lic. N404—WoClass Contractors E-mail Address fi" Z) Zip j(176_s Telephone'7f4 3 S? I (L f PERMIT NO. PLAN CHECK NO. PLAN CHECK FEES $