HomeMy WebLinkAboutXR2022-2259 - Permit ApplicationWaOgO __ Print Form Worksheet for Combo Building &Solar Permit Application F
F Comm'I XResidential City of Newport Beach - Building Division �A1 ^�Wq,NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_Gradingf-Drainage D?Elec F_Mech Plum CuvdCut s CuvdFills
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Project Address (Not mailing address) F_ Flood r Fire j- Liq r Landslide [N/A Floor Suite No
Description of Work
f Use Const Type
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as J.,� - -
# Stories # Units (if Res)s
� x � Valuation
New/Add SFRemodel SFe e
Garage/New/Add � Material/Labor
OWNER'S NAME Last /
C�4Tt.S First
Owner's Address A� / Owner's E-mail Addresses
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City ,ii ec jz, vk 3� 4��, State L4
ZIP SZGLO Telephone `l'YS Lc r� �fr2o
APPLICANT'S NAME
Last G Gh%t<iU Firstfl4 4kktc
Applicant's Address Applicant's E-mail Address
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City Ajciac� J%(� State ZS Zip iLC63 Telephone�iY S9-Y-354r
ARCHITECT/DESIGNER'S NAME Last
First � Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip F__7_7— Telephones —
ENGINEER'S NAME Last First F_____7 Lic No.s—
Engineer's Address Engineer's E-mail Address
City State �® Zip �— Telephones
CONTRACTOR'S NAME/COMPANY l ` tL < F Qjrqj,�;G Lic. No.
9SSO 24 Class
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Contractor's Address Contractors E-mail Address
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City AS, —4 (-!r S State Gt Zip )`ZCS—� Telephone 21Y5£ry-35Y/
SETBACKS REAR SETBACKS FRONT PERMIT NO. ! `I 1ZOZZ _ ZZ S I
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. PC U?— Z — Z 1 OS
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $