HomeMy WebLinkAboutX2022-1315 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application o� q
r Comm'I F_ Residential City of Newpert Beach - Building Division
NOTE: PLAN CriECK I EES DUE AT TIME OF SUBMITTAi
F-Building F_ Grading F-Drainage j-Elec rMech F- Plum Cu Yd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) C Flood F_ Fire r- Liq r" Landslide CN/A Floor Suite No
(III CC(F1=_
Description of Work
Use [_ Const Type
# Stories # Units (if Res)F-
l 1
29 LF 6 H cx 2've�
New/Add SFF— Remodel SFF Garage/New/Add �—
Valuation $
Material/Labor �/ 00 O
OWNER'S NAME Last C0 V j (,cJ (LL( First
Owner's Address Owner's E-mail Address
L IL% w S CO, 9) w CLL
City State �— Zip F_ Telephone —
APPLICANT'S NAME Last �iZts y fG First _J-L�F j
Applicant's Address Applicant's E-mail Address
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City `t- LG
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ARCHITECT/DESIGNER'S NAME Last FLO r a� First �— 2� t6 c� Jt
u2 SZ
_ t� Jc¢V w� Lic. No.
Architect/Designer's ner's Address � cy
9 Architect/Designer's E-mail Address A!'P
1 Z03
City �Q p1 T )� p uC q State C %� Zip g Z E (� Telephone F rl � - L
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ENGINEER'S NAME Last First F Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State F Zip I Telephone�—
CONTRACTOR'S NAME/COMPANY Lic No. Class l G �7
3� 1 b (
Contractor's Address Contractor's E-mail Address
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City t _) L 60 Nat State ��� Zip Telephone Cl 5) S n 1-� 3/ �
SETBACKS REAR (y SETBACKS FRONT LO PERMIT NO. KZou"' 1315
SETBACKS LEFT _� SETBACKS RIGHT 4 PLAN CHECK NO. ' zi S - 202Z
USE ZONE DEVELOPMENT NO 17Z 0 2 Z' (J 2 39 PLAN CHECK FEES $ 516q 1 7 Z
WP°kr CITY OF NEWPORT BEACH
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' "' COMNIUNI7l' DEVELOPMENT' DEPARTNIENT
u r. BUILDING DIN ISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach. CA 92658-8915
y. www.newportbeachca.eov 1(949) 644-3200
AGREEMENT TO BUILD A FENCENUALL CENTERED OVER THE PROPERTY LINE
THIS AGREEMENT has been entered into by the following property owners for the construction
of a common property line fence where 50% of the wall thickness and foundation will be built
over the adjacent property.
This is a sample form intended to asset both parties through the permrffmg pro ass, It is no! Intended to addmss any property nahts
or legal issaes. Any otherforms of agreements maybe rued as long as it contains the basic information herein.
SUBJECT PROPERTY ADDRESS: ,. (.�_�
PRINT NAME SIGNATURE OF PROPERTY OWNER DATE
ADDRESS OF ADJOINING PF
'U—A e--s )�)1 r/
PRINT NAME
ADDRESS OF ADJOINING PROPERTY 2 (See key plan):
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AD TE
PRINT NAME SIGNATURE OF PROPERTY OWNER DATE
ADDRESS OF ADJOINING PROPERTY 3 (See key plan):
PRINT NAME
KEY PLAN
I
PROPERTY 1 f
fi mc'-PM lim'•a11 :.greeaeo12016.0tl.0
SIGNATURE OF PROPERTY OWNER
PROPERTY2
---•----•-----STREET
DATE
PROPERTY3: