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HomeMy WebLinkAboutXC2022-2010 - Permit ApplicationPrint Form orksheet fpprr Combo Building & Solar Permit Application @RA N022 -2©lC��omm I Resdential CL of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL wilding F_ Grading f—Drainage ;,-,Elec F_Mech /Plum CuvdCut s CuvdFill s Project Address (Not address) r- Flood f Fire F_ Liq r Landslide 1-N/A Floor Suite No `mailing Description of Work Use ConstType(m �(Y✓Y�- # StoriesFT # Units (if Res)[ — "A Valuation $ Material/Labor�� New/Add SFF— Remodel SFs Garage/New/Add �— OWNER'S NAME Last _ I (�L�i�Dl _ _ ��ir L✓. Owner's Address Owner's E-mail Address City TLSnVN State Zip Fi 27�' Telephone 56P 733- 30i34, APPLICANT'S NAME Last `'` f First Applicant's Address Applicant's E-mail Address IX IMCICA 5ie-_ , City�� State Zip 6L&Lg Telephone ARCHITECT/DESIGNER'S NAME Last pp � ��� 1—L"`J�- till 9; � First �(�� Lic. No. // Architect/Designer's Address Architect/Designer's E-mail Address 1;, _ 1114uLA_c _ se= ir, City TM� e State Fa Zip 2J;71 Telephone g oet 4-y5z- ENGINEER'S NAME Last First ��C2l.P Lic. No.� 3L� Engineer's Address Engineer's E-mail Address im �✓ (16�r �K � p , v ek P 3[wc_- .�y City K�bk jL. ���- State Zip l Telephone ;rlij- CONTRACTOR'S NAME/COMPANY Lic. No. s— Class Contractor's Address Contractor's E-mail Address City State F_— Zip F Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. XCZOLZ Z010 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. fpc Z 0?2.ZS45 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $