HomeMy WebLinkAboutX2022-0223 - Permit ApplicationPrint Farm Worksheet for Combo Building $ Solar Permit Application
r; Comm'I esidential City of Newport Beach - Building Division cm_ -oaa3
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X
[Building ❑Grading F-Drainage r,Elec
roject Address (Not mailing
2 f - l%V )A�!ti",
of Work
[Mech F. Plum cu Yd Cutl ,, Cu Yd FIII
C Flood [Fire [ Liq C Landslide rN/A Floor Suite No
C F__
New/Add SF�, Remodel SF Garage/New/Add
OWNER'S NAME Last
First
Use C' ConstType C
# StoriesF_ # Units (if Res)F_
Valuation$ .�
Material/Labort�
Owner's Address Owner's E-mail Address
City I -=_1y! / t C� State r CA— Zip[ �2,_, Telephone `i i.[ 1 is / 6 6 9 7 -E
APPLICANT'S NAME Last
First
Applicants Address Applicant's E-mail Address
City State r Zip , Telephoned',
ARCHITECT/DESIGNER'S NAME Last I i'k? L/Q2;72- First
SI L 26 1 � Lic.No.�
ArchitecttDesigner's Address Architect/Designer's E-mail Address S 1 S
.J -
`2- S7- L P45-Fto C'k 2--FO 61017\61FCd,th/6LIO71iA 41
City "li c w 3 A n i ¢ State [7�7T Zip 6); et Telephone � y''/ 694
ENGINEER'S NAME Last First Lic. No.�
Engineers Address Engineer's E-mail Address
City _ _ _ State Zip F__ TelephoneF_
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City State
Lic. No.F--ClassC
Contractor's E-mail Address
Zip F7— TelephoneF_
SETBACKS REAR SETBACKS FRONT 7.'l0�� — UL jl� S PERMIT NO. Z C C-2
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. (jzL-(2- -- Z-�Z Z
USE ZONE DEVELOPMENT NO 7 r - ➢ J�LAN CHECK FEES $