HomeMy WebLinkAboutX2022-1129 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o?EWaoR�
F_ Comm'] f- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_ Grading F-Drainage r Elec F_Mech F- Plum Cu vd Cut Cu Yd Fill F
Project Address (Not mailing address) C Flood r_ Fire F_ Liq F_ Landslide 1-N/A Floor Suite No
�U RUC Deduv',Ile�—
Description of Work
Use F— ConstTypeF_
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# StoriesF— # Units (if Res)F—
Valuation $
Material/Labor
New/AddSFF_— Remodel SFF Garage/New/Add —
OWNER'S NAME Last F17177First
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Owner's Address Owner's E-mail Address
4 1''ae p «uVille
ti= w�= l Zip 7,Z6 o Telephoned —_--
city " _` !? " S �` State
APPLICANT'S NAME Last flaFirst AbclulY'rtitiw.a��
Applicant's Address Applicant's E-mail Address
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cityc State a in A ha -. C {I Zip .- 1 70 i Telephone 99 4U z 4 72 i
ARCHITECT/DESIGNER'S NAME Last to First—'
-_ tw Lic No.
ArchitectlDesigner's Address Architect/Designer's E-mail Address
City State �— Zip F-Telephoned
ENGINEER'S NAME Last 1 f i a w First j��a le l Lic. No. f 5,
Engineers Address Engineer's E-mail Address Til E 2 (
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City t„ _tee ;nti e. Mkr9nrlfa State L,1 ZiP 11679 Telephone
CONTRACTOR'S NAME/COMPANY B , "c �e� �. \ �� Lic No. ,v jZCS Class
Contractor's Address Contractor's E-mail Address
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City L a) ; _, a li I ls. State if ,) Zip -12- 6 S� Telephone ?rT=. Sn
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SETBACKS REAR SETBACKS FRONT PERMIT NO. A
r
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. JW e
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $