HomeMy WebLinkAboutXR2022-2244 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'] XResidential City of Newport Beach - Building Division
NOTE: PLAN CHFCK FFFS nl it AT Tinno nr ci JDAfil A i
Building F_ Grading F--Drainage XElec XMech xPlum CuYdCut [_ CuvdFill oP
Project Address (Not mailing address) [ Flood f.- Fire I- Liq r Landslide F_N/A Floor Suite No
c�r�st c A , C-Q,011'"t�A�,�`i' z � z� ( I—
of Work
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Usescription
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# Stories # Units (if Res)r
New/Add SF Remodel SF � j(� Garage/New/Add �
Valuation $ �C) OO G
Material/Labor �
OWNER'S NAME Last First
Owners Address Owner's E-mail Address
City State �— �- (q
Zip . Telephone .
APPLICANT'S NAME Last 1
First �-� �✓\
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Applicant's Address Applicant's E-mail Address
City ' y+�t) �� e � , Zi Tele hone
State �— P 1 2 b �. p 1 14 ->I t,- 44(L
ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No.
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City State Zip F Telephoner
ENGINEER'S NAME Last First F Lic. No. F-
Engineers Address Engineer's E-mail Address
City State F_ Zip F— Telephone—
CONTRACTOR'S NAME/COMPANY c No. JOS311 -f _7 Class C ��QY� I} �� oY\5�Li
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Contractor's Address C e
Colntractor's
tt -Er-mailAddr-etss �
SS�i� r ctiS �� .It�nh� ale-an`Ce'✓�S1tivCTl�v me 'ti Nc�
City State �— Zip ! `II� 11 ,
Telephone /Lr SIC -11,"fi ,
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0- Z
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USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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