HomeMy WebLinkAboutX2022-0091 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I ResidentialCity of Newport Beach - Building Division
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Project Address (Not mailing address) F_ Flood [_ Fire F- Liq F_ Landslide F-N/A Floor Suite No
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Description of Work
- -A- Use ' Const Type
_1 �LC4�-�: �.- I l # Stories # Units (if Re;s))7
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Valuation $
New/Add SFF Remodel SF % vC C) Garage/New/Add Material/Lab 100 (�?00
OWNER'S NAME Last WAG i First
Owner's Address jj /� So Owner's E-mail Address
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City State
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APPLICANT'S NAME Last First �G U
Applicant's Address - Applicant's E-mail Address kv t
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City State Cam,,, Zip Telephone F� ?V 7�.00
ARCHITECT/DESIGNER'S NAME Last �i bl o. First FM —441 Lic. NoC`6 7S5
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Architect/Designer's Address Architect/Designer's E-mail Address
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City 6 State Gw Zip Telephone 17V 1 <0 885
ENGINEER'S NAME AL)as First F Lic. No.1
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Engineer's Address Engineer's E-mail Address
City State F— Zip [_ Telephoned
CONTRACTOR'S NAME/COMPANY �,t J� 1� Lic. No. y86J 97 Class
Contractor's Address ,v Contractor's E-mail Address
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City State Ca. Zip 7 y6'6Z Telephone q7 9 37�J 7ZU0
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
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