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HomeMy WebLinkAboutXR2022-3178 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o a `_ - 9 pp j- Comm - Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building F_Grading f-Drainage -Elec rMech F- Plum Cu Yd Cut F_Cu Yd Fill Project Address (Not mailing address) 1- Flood F_ Fire F_ Liq r Landslide rN/A Floor Suite No 20� I � � � ol�G►�E � I� _��T �T Description of Work iJ64 I ,YdPlvt 1'or Use F_ConstType� L) bl,b arc[ u_ # Stories #Units (if Res) -�{ Valuation $ /'UO Material/Labor ` !/ New/Add SF�- Remodel SFF Garage/New/Add F OWNER'S NAME Last 7 G First©�M Owners Address Owner's E-mail Address f 'OFZT __ 1ra-TOl__G� tnorm. 0q\/,1-Usa_, Com a City State — Zip Telephone 3 FO�T C�- Zlo fo D �� 70(0 7q 1 . -� 2 7 APPLICANT'S NAME Last %t First\� Applicant's Address Applicant's E-mail Address T 27071�7 CAMIT E✓rE 105 Berry®ad��alrt; ,�.ne A/�1 sett _ City Lr�V� 1 4iL�G State CA Zip cT,1, Telephone�1 t � I Z— I (3cj ARCHITECT/DESIGNER'S NAME Last First FLic. No. �— Architect/Designer's Address Architect/Designer's E-mail Address City State F Zip � Telephone — ENGINEER'S NAME Last First V �jLic. No. C 3w , Engineer's Address Engineers E-mail Address 1. 1�AVE, D Yag�`1�etn��n�ers the .� City State l u d Zip Telephone (� 1q 12-0 CONTRACTOR'S NAME/COMPANY 1l lv \ I Lic No No. ?�3 SayJ Class 1 % IVCoonntractor's Contractor's Address C E-mail Address 27101 CJ C> IeCT 1Z0• STt; 10 � 5 Leo-rry@ City>Q,( l,IjNA � I ILLIC.�T S State Zip t Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK 1\10. t2�Z02 Z— USE ZONE DEVELOPMENT NO PLAN CHECK FEES $