HomeMy WebLinkAboutXR2022-2169 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application
F Comm'I j- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I -Building F_ Grading F-Drainage r Elec F_Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r- Fire [7 Liq r Landslide F_N/A Floor Suite No
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Description of Work
Use I „�,I� ConstType F
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# Stories # Units (if Res)
Valuation $
Material/Labor (�
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New/Add SF Remodel SF TGarage/New/Add F
OWNER'S NAME Last LC�ll`I� }r�'Jl'l�c LLC- First
Owner's Address ,� Owner's E-mail Address
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city Slate
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APPLICANT'S NAME
Last First.
Applicant's Address Applicant's E-mail Address
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City r j L CL 1k { ,1 State f zip c Tele hone
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ARCHITECT/DESIGNER'S NAME Last
I�l t `,.. First } t: r ` Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
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City lad' N , t� slde P Tele hone 7 C
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ENGINEER'S NAME Last First
,f, k� Lic.No.
Engineers Address Engineer's E-mail Address
City �' t i L t, State L" /-1 Zip F Telephone '
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CONTRACTOR'S NAME/COMPANY Lic. No. F— ClassF_
Contractor's Address Contractor's E-mail Address
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City State F Zip I TelephoneF_
SETBACKS REAR SETBACKS FRONT PERMITNO. A;� • ZI +
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. JC �t7l�i•Zt�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $