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XR2022-2326 - Permit Application
Print Form Worksheef for Combo Building & Solar Permit Application �a�Wp�RT City of Newport Beach -Building Division j— Comm'I (_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F—Building Grading Drainage j—Elec F_Mech F— Plum CuYdCutF CuvdFill Project Address (Not mailing address) f✓ Flood F Fire j_ Liq r Landslide F_N/A Floor Suite No Description of Work Use F—Const Type F_ OoAl�kxd a le - # Stories # Units (if Res) �2 / �Q� -- I y _. Valuation $ Material/Labor ¢ y New/Add SF Remodel SF Garage/New/Add Y OWNER'S NAME Last First Owner's Address Owner' E-mail Ad ess -_ G.,�(.�- City State _ .. Zip 9I TelephonerpJr O QOZ-Z APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address eO7 vM4"Oefl 4. City State _ Zip Telephone ARCH ITECT/DESIGNER'S NAME Last First Lic. No. F -_ Architect/Designer's Address Arch itect/Designer's E-mail Address F7 City State �! Zip �— Telephone - ENGINEER'S NAME Last First F Lic. No.s Engineer's Address Engineer's E-mail Address City State s_ Zip 7 Telephone CONTRACTOR'S NAME/COMPANY Lic. No. s- Class Contractor's Address Contractor's E-mail Address - City State s Zip-�--- Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. C_ '7 Z�Z,3-Z� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. /ry U USE ZONE DEVELOPMENT NO .)7—©Z-1 ` VS I s PLAN CHECK FEES $