HomeMy WebLinkAboutXR2022-2223 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I j Residential City of Newport Beach - Building Division /gyp
NOTE: PLAN CHFCK FFFR Ill IF AT Tlnn❑ nr OF loon rrrnl X t��lv
- -I -v"'r1L VVVUIVIII 1/'}L �4cOwMr�
NIBuilding r- Grading r-Drainage F-Elec Mech r Plum Cu Yd Cuts Cu Yd Fill
Project Address (Not mailing address) F Flood F- Fire F- Liq r- Landslide FN/A Floor Suite No
Description of Work
Use F— Const Type
` 1
# Stories # Units (if Res)s
New/Add SF Remodel SF - c Valuation $F
I `� S Garage/New`/Aad �— Material/Labor `
OWNER'S NAME
Last ��l � i_^�, fVA4 JI'\ First
Owner's Address
7 wn E-mail Address
City ' . State FIN l Zip ` � / f TelephoneF—
APPLICANT'S NAME Last L ; ` 1'(- First
Applicant's Address Applicant's E-mail Address
6�tic-
City U,\ V! f State l Zi ... r L...
_. P �. l Telephone
ARCHITECT/DESIGNER'S NAME Last
_ _ First �— Lic. No. F--
Architect/Designer's Address Architect/Designer's E-mail Address
City �— State r— Zip F_ Telephone
ENGINEERS NAME Last First F— Lic. Nos—
Engineer's Address Engineer's E-mail Address
City State [_ Zip F— Telephoner
CONTRACTOR'S NAME/COMPANY : -
Lic. No. U ll�'`I`I� ClassI J
Contractor's Address Contractor's E-mail Address
City ('.. Jla State ( ''; Zip C.CL Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.jCY
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. f 1. C La l y lv L
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $