HomeMy WebLinkAboutX2022-0403 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar P111,t%;?cation
F- Comm'] r Residential City of Newport Beach - Building Division 30I,
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL CF00.NP
(?Building r' Grading
F Drainage r Elec r', Mech Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) r Flood j-"- Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
Use Const Type j
'D E-finL l dl7 + (vI NITS 80x Fok FuT u
# Stories F„ #Units (if Res)
Soap- 3 coo 300
Valuation $
Material/Labor >
New/Add SF�
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Remodel SF 'i 5011 Garage/New/Add e/New/Add I s
OWNER'S NAME
Last C�i<fiNiTlr if'R•e, l'f�1 �5 First
Owner's Address
Owner's E-mail Address
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City 1Fwroq--T BF-o r{
State
.. �..........__ Zip gZ(6Q Telephone
APPLICANT'S NAME
Last _ __ _..... First
Applicant's Address
Applicant's E-mail Address
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City I (ZV j (� G
State �' r
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ARCHITECT/DESIGNER'S NAME
Last 0 First
1 DI(:.K� N Lic. No rG—jzzl^1
Arch itect/Designer's Address
Arch itect/Designer's E-mail Address
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L)UiTE cj�d C�j�LkS�s'i OGtYGk1vfC,6a
City (Z J i NE
State (+; Zip Z6 �y Telephone
ENGINEER'S NAME
Last P r) A First F Lic. No.r_
Engineer's Address
Engineer's E-mail Address
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WA1 hrisl' P�a--en corn► _.
City I i N
State (' Zip j 2 16 Telephone
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CONTRACTOR'S NAME/COMPANY
\\nn \\ Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City �/`�Y 1(�
State Zip Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. XZU2Z� D�{o2�
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 036q .Zp y2
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $