HomeMy WebLinkAboutXR2022-2020 - Permit ApplicationPr,.-. Form -a Worksheet for Combo Building & Solar Permit Application �£� °R>
r Comm'I r Residential City of Newport Beach - Building Division -�
NOTE: PLAN CHECK FEES DUE AT TIMF nF SI IRMIrrAI
[Building F_Grading r-Drainage r-Elec I-Mech r-Plum Cu Yd cuts Cu Yd Fills
Project Address (Not mailing address) F7 Flood F_ Fire I- Liq r Landslide F N/A Floor Suite No
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Descript on of Work
Use ConstType
# Stories # Units (if Res)F
/
New/Add SF Remodel SF Garage/New/Add
Valuation$ 11 _
Material/Labor (% ✓ �x
OWNER'S NAME Last ` +� First
Owner's Address Owner's E-mail Address
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City w MV V State t �1 Zip Telephones
APPLICANT'S NAME fpp j Last t � f � Lli �� -
First .� .
1
Applicant's Address 1 Applicant's E-mail Address
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City i�l y State Zip G ` Telephone[\
ARCHITECT/DESIGNER'S NAME Last First —
Lic. No
Architect/Designers Address Architect/Designer's E-mail Address
City State F Zip �— Telephones--
ENGINEER'S NAME y/j., Tv Lic, IC. No /,
Last w i First i
Engineers Address Engineer's E-mail Address
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City I �' tlA � - State Zi /-T-z4 � p //
L - p L ?ele hon `{
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CONTRACTOR'S NAME/COMPANY i J /1, j, j J r Lic No. '
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Contractor's Address Contractor's E-mail Address
City State F— Zip F_ Telephoned®`
SETBACKS REAR SETBACKS FRONT PERMIT NO. kJ21)22- f 30L(/)c,AW2 -2_ JW
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $