HomeMy WebLinkAboutX2022-0285 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
�i Comm'I r Residential X20-12 '02" 9SCity of Newport Beach - Building Division �Q� ern��er ®row �Draina e NOTE:PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �l
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Description of Work
Use Const Type
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-b I V I e 1 S t V►ICr �f I 3 I IQ{1�S 1� C�r"QcS_ Q. �., # Stories #Units (if Res)
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New/Add SF� Remodel SF Z, S I Garage/New/Add �_' Valuation $ / f1 D VV7"
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OWNER'S NAME Last � First
Owner's Address - - - - --
Owner's E-mail Address
City State—! Telephone
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APPLICANT'S NAME Last
First
Applicant's Address -.-'�` 1- -- -----_J
Applicant's E-mail Address
city F State
Zip Telephone
ARCHITECT/DESIGNER'S NAME
Last �- First
- - j Lic. No.
Architect/Designer's Address -----------------�
Architect/Designer's E-mail Address
- -- -
-
City- --
State Zip Telephone
ENGINEER'S NAME Last
First
--- F Lic. No.F j
Engineer's Address Engineer's E-mail Address
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CityState
ZIP �� Telephoned
CONTRACTOR'S NAME/COMPANY SbhV%,j --B (til (de 'I -Lic. No.
Class
Contractor's Address _-
.
Contractor's E-mail Address
- --
city 12.sC(/�11 6Y
tau) R31 -
_ I State � - i Zip
a ���p Telephone
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. X2022. -OZ85
PLAN CHECK NO. OZ 55 _ ZcZZ
PLAN CHECK FEES $