HomeMy WebLinkAboutXR2022-2881 - Permit ApplicationPnnt Form__ Worksheet for Combo Building & Solar Permit Application Rr
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Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL -
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g [ Grading f-Drainage F- Elec F_ Mech Plum
Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F7 Flood j-" Fire � Liq r Landslide F_N/A Floor
3�J CN��/�� Suite No
Description of Work
PiTF�Pi1 �fN� f�%6/�!6�EpLjf Use ConstType {�/✓
J�rCac �6� ( RS kI K g' #Stories # Units (if Res)
F—_
New/Add SF�— Garage/New/Add Remodel SF�— Valuation $
------ Material/Labor
OWNER'S NAME Last
First ���
�Ow�ne�sddress -
Owner's E-mail Address
�.FNooN
City State C,4,I -
- --- - - -- Zip -126�-7 Telephone-
-----
FApplicant's
Last
L /SZ/f� First p�F[O
Applicant's E-mail Address2� c State - - Zip ��/2 Telephon `%YZ9� ✓----
ARCHITECT/DESIGNER'S NAME -
Last First /"/��
I Zo
G/SC1 Lic. No.
Architecf/Designer's Address - -
Architect/Designer's E-mail Address
-
city - --------- -- - - -
State Zip Telephoner
ENGINEER'S NAME Last _ Fi /1
First -ri0 - - Lic. No.
Engineer's Address
Engineer's E-mail Address
City - -- - -- --- --- - - _ State Zip �— Telephoner
CONTRACTOR'SNAME/COMPANY
Lic. No.�S / Class
Contractor's Address -
Contractor's E-mail Address
Y 9�1 C�or io�t �r/l �D
City (A �� �ls/-r2�dC`State Cj� zip F — Telephone
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SETBACKS REAR SETBACKS FRONT `
PERMIT N0. Xie�E — 2
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO�% �Z9
USE ZONE DEVELOPMENT NO
- PLAN CHECK FEES $