HomeMy WebLinkAboutXC2022-1946 - Permit ApplicationL . Print Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach -Building Division
f- Comm'I F_ Residential V
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL_
C 9 Z Z I "� 4 (0
'Building Grading f—Drainage r— Elec F Mech Plum Cu Yd C,t Cu Yd Fill
Project Address (Not mailing address) r— Flood F_ Fire F_ Liq f— Landslide [_N/A Floor Suite No
10-6. _7_ .. . .... .....
Description of Work
Use F Const Type
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# Stories F/_�- # Units (if Res)
Valuation
MateriaKabor
..... ...... A,..V4K—.. ......... ....
New/Add SF1._....,._..,_ Remodel SF1_1._ Garae/New/Add
gF—
OWNER'S NAME 111741 First
Owner's Address Owner's E-mail Address
4V
e
y I citF. State 7 zip
APPLICANT'S NAME Last First F
Applicant's Address Applicant's E-mail Address
Cf i rl C v i
k
(7—
C . I State zip Telephone
City F 66 S2
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
. ..... .. oto
City State F Zip Telephone'
17
6
CONTRACTOR'S NAME/COMPANY Lic. No. Class
F
Contractor's Address Contractor's E-mail Address
0 1 I try V
5 WC
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City 5,J/ JUIJ P6rj (je State F-('7[ Zip Telephone
5 0
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $