HomeMy WebLinkAboutX2022-1020 - Permit Application (2)92022 -102-D
Worksheet for Combo Building & Solar Permit Application
Comm'IResidential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
MBuilding ❑ Grading CDrainage ❑Elec [ Mech j7 Plum
Cu Yd Cuts l
Cu Yd Fill s
Project Address (Not mailing address) ❑ Flood ❑ Fire C Liq
n Landslide
❑N/A Floor
Suite No
C- D.3 7(Qt-vPT-
e-C,N
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Description of Work Use n Const Type L J
R,iF- J ?-F-0
# Stories # Units (if Res)F7
�`i 41&"Pe , ZP -tom W= P>RyVI AIL L,/
------------�- Valuation $fr-
�/,S�New/Add SF� Remodel SF� Garage/New/Add J Material/LabL /
OWNER'S NAME Last���y First L 1�3LA-- - -
Owner's Address Owner's E-mail Address
City State
---- - Zip]��� Telephone
APPLICANT'S NAME Last - - First
Applicant's Address Applicant's E-mail Address
----------- ------------
City State F-- 7- Zip= Telephoned
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
---- -- --- -- -- -- -J ---�
City State - Zip F-777TelephoneF
ENGINEER'S NAME Last �— First F— Lic. No.�
Engineer's Address Engineer's E-mail Address
City — - —� State L Zip I Telephone
CONTRACTOR'S NAME/COMPANY � Lic. No. (6M,4-qS Class
Contractor's Address Contractor's E-mail Address
City j 1 1J State Zip �/ /, Telephone�j� �J q �nl // �f
_l`� - ----- - - -- I = _-1 00 `G 1 ! (t LF C? �To I
SETBACKS REAR SETBACKS FRONT PERMIT NO. XZ2SZiZ - I D Zo
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. QgC0 -?y 7_-Z_
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $