HomeMy WebLinkAboutPV2022-044 - Permit ApplicationI IR
PNIO21 -044
apr/} Worksheet for Combo Building & Solar Permit Application �.
I— Comm'I ( Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
{Building r. Grading rlDrainage [,ElecrMech [-`:.Plum cu yd cuts; Cu yd Fill l !.
Project Address (Not mailing address) r Flood r Firer Liq r Landslide rN/AFloor Suite No
Description of Work Use � T7 ''
-
�W od Ot-tIJ ®O �w - ConstTyPe '
It Stories # Units (if Res s'
fw_ -oma - �.
Valuation $
New/Add SF[", Remodel SF� Garage/New/Add Material/Labor C) !
OWNER'S NAME
Lastc��K_ First
Owner's Address Owner's E-mail Address
City ... _0��--.C�.+ State Zip.. Telephone�G� S'
APPLICANT'S NAME LastFirst/ _
.. _ ....
Applicant's Address Applicant's E-mail Address
' >_2(�� /G�1._._ Spft(0t,t __ F_lepL grn o�,I soua—c'F � •c _
City _D�}V� L _-- --_. _.._ ..- State C�/-�..`. Zip
ARCHITECT/DESIGNER'S NAME Last ,� First LIc. No. 1 _
Architect/Designer's Address Architect/Designer's E-mail Address
- ---_ .---- ....._ .. -... -------
city _ .. State .Zip rte__,_- Telephoned
ENGINEER'S NAME Last ��/'ii(� _ First Lia No.l'
Engineer's Address Engineer's E-mail Address
City State �� Zip �� Telephones;
CONTRACTOR'S NAME/COMPANYi�1�j . %j,Q�'� I Lic. No. y y� Class
Contractor's Address Contractor's E-mail Address
c1).t72_Fla_mtN _ t-yP _ q
City %. State ZiPVZ /1 TelephonePZ
Fa2p..92,a
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REAR SETBACKS FRONT PERMIT NO. `�1VLOt.,t- 044 61ri -ai2
LEFT SETBACKS RIGHT PLAN CHECK NO. DEVELOPMENT NO PLAN CHECK FEES $