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HomeMy WebLinkAboutX2022-0220 - Permit ApplicationF!r(nt Form;. I Worksheet for Combo Building $ Solar Permit Application F-1 Comm'I IV,,Residential City of Newport Beach -Building Division x202'1, -Q 2`O NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building r_7 Grading Drainage ❑ Elec [7 Mech [- Plum curd cut cued Fin L Project Address (Not mailing address) CI Flood ❑ Fire (-I Liq F -j La llndslide ❑N/A Floor Suite No Description of Work Penovt✓ eK16,h • a It I w 2 t1 �tJ New/Add SF Remodel SF F— Garage/New/Add—I OWNER'S NAME Last Iheainef5 EOMMUn17Y Firstr Use n Const Type FI # Stories # Units (if Res)n "r Owner's Address 77 Owner's E-mail Address _7i I t -1I VIZ,+, `e_l Oro ---------1 City State F 6F Zip Telephone N71 4S " IZa� APPLICANTS NAME Last First a✓N S Applicant's Address Lt X70 --- - -- - --�-- - City �iV\�e State L "CC.._...I Applicant's E-mail Address �vla �Gtns Z G C r( C�v�t - -- ---------- - --------- Zip q va t %7 Telephone�/k�j-�UZ_Cl74 ARCHITECT/DESIGNER'S NAME Last �— First F Lic. No. F I ArchitecttDesigner's Address ------------------------------------------------------- city —i State 77 ENGINEER'S NAME Architect/Designees E-mail Address Zip [_ Telephoner Last --- - -- - First Engineer's Address City Xn�7Lt_9�ta ' ft ie, j State Lic. No. p_I Engineer's E-mail Address — m Zip Telephone�N� CONTRACTOR'S NAME/COMPANY ��� I2L ! Lic. No. Class Contractor's Address Contractors E-mail Address _ Soo --- — ' �la� ! City kfoil C ---- _-- State L I Zip ��tt� Telephone �(Q�7 �UZ-�I (� SETBACKS REAR SETBACKS FRONT PERMIT NO. `vV SETBACKS LEFT SETBACKS RIGHT ` PLAN CHECK NO. t USEZONE - novo nonnoKM Kin/�f1(%. 91_� %7 o1 AK1. U,i,0 A,—'Ir— /_7�'"