HomeMy WebLinkAboutXR2022-2533 - Permit ApplicationPrint Form J Worksheet for Combo Building & Solar Permit Application �EWPoa>
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j Comm'I F1, esidential City of Newport Beach - Building Division J _ aG��
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FC,Bi iIdIng F_ Grading F-Drainage r-Elec F_Mech Plum Cu vd Cuts Cu Yd Fill s
Project Address (Not mailing address) F- Flood F_ Fire i- Liq F_ Landslide I -N/A Floor Suite No
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Description of Work Gti,47-r A A" 'A d l P j-S rG,T N y-7drU
Use �L-�GCOnstType i7-6
I2 %Lls2a� V7'Z J / �
# Stories # Units (if Res)
Valuation $ r, c
Material/Labor I S r'/
/CAA/_ /2>IP i/u'SGK .�(s I�C�
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New/Add SFsgamaTel SF J �Je Sr Garage/New/Add F-
OWNER'S NAME Last jf1 % /%/ First
Owner's Address 0
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City State �— Zip �— Telephoned --
APPLICANT'S NAME Last 1 jzU A �.[ First )A y
Applicant's Address Applicant's E-mail Address
. �"C.Z�%� OG`f/ COIF C062f
City 1 AL hpA SS(AAIJ State �C A r
Zip /c, 62 Telephone 3 if
ARCHITECT/DESIGNER'S NAME Last First y
Architect/Designer's A.fddress Architect/Designer's E-mail Address
City State r— Zip � r_elephon _ _ _ _ _
ENGINEER'S NAME Last First Lic. Nos —
Engineer's Address Engineer's E-mail Address
CitY State F Zip �— Telephone
CONTRACTOR'S NAME/COMPANY Lic No. C� Z� U 7�L Class
J J U
Contractor's Address Contractor's E-mail Address
City State F— Zip � Telephones_
SETBACKS REAR SETBACKS FRONT PERMIT N0. ) ?4±2a ��✓'y3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. "1G Ut2-23'13
USE ZONE DEVELOPMENT NO _ PLAN CHECK FEES $