HomeMy WebLinkAboutPV2022-062 - Permit ApplicationI F?rihtform Worksheet for Combo Building & Solar Permit Annfication �EWPoR>
F-1,Comm'I ri Residential City of Newport Beach - Building Division P �`VIVI,
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °+o.ace�•
-Building -Grading j -Drainage [-i Elec -Meth
-Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) - Flood
r ; Firer Liq - Landslide -N/A Floor Suite No
Description of Work
Use F-1 Const Type I
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# Stories[ # Units (if Res)F_
Vtr%X__.
Valuation $
New/Add SFRemodel SFr— Garage/New/Add Material/Labor 7 �b
OWNER'S NAME' Last l—
First
Owner's Address ;.
Owner's E-mail Address
City�— State �—
Zip � Telephone—1
APPLICANT'S NAME Last �Q�tp
I First
Applicant's Address
Applicant's E-mail//Address
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y,�ia^LI�✓L(Xzl7G'V�VIP�tQ SIJ'A�Q.Gbw�
City �r/✓Yf l� U✓ State Zip (�'7� � Telephone 530 5-;,
ARCHITECT/DESIGNER'S NAME Last �—
'First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F_— Y—II State �I Zip
�— Telephoned
ENGINEER'S NAME Last �Q J
First Dyl� Lic. No. %b7 $L{
Engineer's Address
Engineer's E-mail Address
City �State Zip
14a e atV-sdae I avLs .G�
Telephoned,
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CONTRACTOR'S NAME/COMPANYLic.
Ur _%o 14 64��d
No. G(ua 115 'Class � ) 0
4a r _
Contractor's Address
Contractor's E-mail Address
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City State Zi
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Tele hone
F_ -,p �Z )oi7 4p71
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SETBACKS REAR SETBACKS FRONT
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PERMIT NO. ZLyTii+•
SETBACKS LEFT SETBACKS RIGHT
9065 PLAN CHECK NO. U4 6 • W ✓G
may,
USE ZONE DEVELOPMENT NO Yr 24 •g
PLAN CHECK FEES $