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HomeMy WebLinkAboutX2022-0325 - Permit Application (4)Orint For Worksheet for Combo Building & Solar PeFmit Application [' Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F_ Building j- Grading ["Drainage j- Elec (- Mech r Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) F_ Flood r Fire j- Liq r- Landslide j—N/A Floor Suite No L_A Description of Work Use Const Type # Stories[ #Units (if Res)[ 11 MI5 af�yL�1�Al ©� 7 /�112tzff8�A)s 16A) f1`I ltj-S Valuation $®� Material/Labor New/Add SF Remodel SF Garage/New/Add OWNER'S NAME Last I no # First Owner's Address Owner's E-mail Address 5A A,- City _ State Zip Telephone APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State Zip Telephone_ fAE Last `�� � First � Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address F1 34' AITr-,'10,4- IV,¢1/641z W City �/�bt% �ye A) ( State G Zip 2(,07Telephone /�G� A �� ENGINEER'S NAME Last I f-,S / �--rYje First Lic. No. ,e;ewV d-t-0 dt^ L Engineer's Address Engineer's E-mail Address // City �r1 � /� A tjA- State � Zip 42 70 f TelephoneF— CONTRACTOR'S NAME/COMPANY d pi Al t_a- / I�L9� Lic. No. �— Class / j Contractor's Address Contractor's E-mail Address City State F Zip Telephoned_ SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $