HomeMy WebLinkAboutPV2022-166 - Permit Application�v 2022-i I Worksheet for Combo Building & Sol¢ CP
NOW
o _lar Permit Application ON
1- Comm I F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding [!Grading r;'Drainage rElec r!Mech f-; Plum cuvdcutF cuvdFiu)
Project Address (Not mailing address) (- Flood r Fire rI, Liq F, Landslide r_.N/A Floor Suite No
�9�2 1�or-F Co�Woro( (ir'r i
Description of Work
Use Const Type I"B
# Stories,. # Units (if Res)Fl
Z3 PV qandS. Ntf'C" Jnverlr'uT It /'oa-� Xbf,.' ej /&,r4 i
i
Valuation $ QpU
Material/Labor / /
New/Add SF F� Remodel SF f Garage/New/Add ��
OWNER'S NAME Last �'�p, •ya� ! First -
Owner's Address Owner's E-mail Address
I qB,Z PO /4 Pwwd G�_
City -.IUGu�ir!- f,�lf'!%t _ State Zip g2.�16v� Telephone .Zl...-/,33-g_;Z$^
APPLICANT'S NAME Last �arrbu ,,.,. First Vl•h
Applicant's Address Applicant's E-mail Address
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113�r3/—_l1%. lk,((d, J�-_ e L/i7ki /i�So(nf/f•,�/evM _._...
dvf.)
City !�'� !"1�fe State �i/'�-..... Zip I ui �i� Telephone 9r'9467-�l93
ARCHITECT/DESIGNER'S NAME Last First �'� Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State ! Zip F Telephoned
ENGINEER'S NAME Last fubrAkr First F,�OL,q....... Lic.No.69(63.....
Engineer's Address Engineer's E-mail Address
City �— State F—' Zip Telephoned,
CONTRACTOR'SNAME/COMPANY Lic No. 62%2`*' Class 76
_ Sol4� /J.
Contractor's Address Contractor's E-mail Address
933 _ n��W� rl Sf ✓'A e CAO.4
City State&OIL Zip. !%�6La... ' Telephone loo -V g J_ 3933
SETBACKS REAR SETBACKS FRONT PERMIT NO. 'QVU v` '' b("
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. `lw r2O�iy
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $