HomeMy WebLinkAboutXR2022-2371 - Permit ApplicationPrint Form Wpo
orksheet for Combo Building &Solar Permit Application o���, q>a
rjComm'I F-[,Residential City of Newport Beach - Building Division �J aU _
NOTE • PI AN ruFru PP GQ nl IC nr T�nnr ..� �.,..,_.-..X �l /
- - -- — - —• •— -• � I NIL Ur SUBMI I I AL
L-,Building f- Grading F-Drainage r- Elec F Mech Plum (� `J
Cu Yd Cut l Cu Yd Fill
Project A dress (Not mailing address) I- Flood r Fire r Liq i- Landslide CN/A Floor Suite No
Description of Work `011 7,1z- "I is /I &. z � ° /`t �/1 ie'.<tJ
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Use�s7 Const Type
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t'if /�:±/y/� X �'X%�- ��y
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# Stories? # Units (if Res)I �7
l c
New/Add SF Remodel SF"` Garage/New/Add
Valuation $
Material/Labor 7 ``'
OWNER'S NAME Last //2- L I -Al First
Owner's Address
Owner's E-mail Address
City ------ State F -
w " Zip �— Telephones--
--
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APPLICANT'S NAME •-- Last 1ZG A i�_ First
/ . C/ /t y
Applicant's Address Applicant's E-mail Address
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City /�,i�C / G/ �� A_II D State A ZI
_ P �ZE E' � Telephone
ARCHITECT/DESIGNER'S NAME
Last 7/vv/it-- / First irk/) I-
Lic. N 2 `_
Architect Designer's Address Architect/Designer's E-mail Address
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City .-State ZIP s— Telephone—
ENGINEER'S NAME Last First Lic. No. F_
Engineers Address Engineer's E-mail Address
City State �—
ZIP Telephone—
CONTRACTOR'S NAMEXOMPANY r ' ` , Lic. No. q4; Class
Contractor's Address Contractor's E-mail Address
City State F �—
zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. A4azz-. 2�0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Cleo 2,4-.��
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $