HomeMy WebLinkAboutX2022-0004 - Permit Application2_0-L. Z — u o o (f
Print Form orksheet for Combo Building & Solar Permit Application &'Iffilio
Comm �aCity of Newport Beach - Building Division6rrl Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALRO DuNG6)Q-I
[-]Building [7 Grading nDrainage ❑FletriMech [-Plum cuvdcut� cuvdFill
--
Project Address (Not mailing address) n Flood F_ Fire n Liq FI Landslide ❑N/A Floor Suite No
Description of Work
Use ConstT e
YP
,Y/1 oF
# Stories17 # Units (if Res)
E)"
-----
----- ----
�j
Valuation $ 3 1 000 K
Material/Labor s
New/Add SF Remodel SF�—
Garage/New/Add �-
OWNER'S NAME LastL J-L-(� ----- --- - - FirstI�W
Owner's Address
Owner's E-mail Address
t
City Com'rt1 State L OU ZipAW_ F Telephone
APPLICANT'S NAME Last Z
First
Applicant's Address
Applicant's E-mail Address
-�Ft-.-L 2
City h State
lQ�
Zi 1 !7 1I Telephone �p 9`OX -�I(C
ir
ARCHITECT/DESIGNER'S NAME Last �— First—'Lic. No.
1
Architect(Designer's Address
Architect/Designer's E-mail Address
I
City State
Zip—i Telephone_
ENGINEER'S NAME Last
First— Lic. No.�l
Engineer's Address
Engineer's E-mail Address
City State
Zip Telephone�—
CONTRACTOR'S NAME/COMPANY
Lic. No. ( 635664f Class
Contractor's Address
Contractor's E-mail Address
City State—:
Zip Telephoned—i
SETBACKS REAR SETBACKS FRONT
PERMIT NO. Y,20 -ZZ -O0o l
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. U (90 S - Zo-Z Z
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $