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HomeMy WebLinkAboutX2022-0585 - Permit Application (2)'"2 Pnnt (=orX212 Dos nt�,`i; Worksheet for Combo Building $ Solar Permit App�icat%n ON F, Comm'I Residential ��/ �+�,City of Newport Beach - Building Division I � k i NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL wilding L7 Grading FDrainage ❑Flet rMech Plum cu yd Cut Cu Yd Fill Project Address (Not mailing address) ❑ Flood ❑Fire F Liq [ Landslide ❑N/A Floor No Suite --4 =1 —�` ---- - - - --- ------------- — '- - -- - -' Description of Work Use ConstType Fy -1 Com) y V,,torles # Units (if Res)n Valuationj" Material/Lor .r New/Add SF� Remodel SF Garage/New/Add "dS OWNER'S NAME Last FirstC(/ Owner's Address Owner's E-mail Address city t i7----- ---- ��I/�- State ZipTelephone Zi APPLICANT'S NAME Last ,/Jn /� First -- Applicant's Address Applicant's E-mail d � ----- t�TV -- ---- ' _ - "-- - city State Zip.---- Telephone - _ D(- -i I( //� _i _ I 30 --, ARCHITECT/DESIGNER'S NAME Last �(/First Lic. No. - -- -- d itect/Designers Addresshi Designees E-mail dress City State Zip Telephoned ENGINEER'S NAME Last v� K� First ��I Lic. No. - --- - I ( jE - --i Engineer's Address `` Engineer's E-mail Address City iL v 0 -©103 State Zip . q Telep �(r___ 77,1 CONTRACTOR'S NAME/COMPANY% �Ce �('7') �j ,ci Lic. No. ZQpGGs� Class /p� T Contractor's Address 11t C G Contractor's E-mail Address �j� i'{ 30192 212 �Q�o� v�o (1tfl access c� @gra 1 _ ca14^ City state `" Zip 1 J A�� -; Telephone I ETBACKS REAR SETBACKS LEFT USE ZONE SETBACKS FRONT PERMIT NO. X L -0Z Z QS$S SETBACKS RIGHT PLAN CHECK NO. Q 52H - 20ZZ DEVELOPMENT NO PLAN CHECK FEES $ Sl 7 r N