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XR2022-2573 - Permit Application
L Print Form_ j Worksheet for Combo Building & Solar Permit Application oF�2 F Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAi F-Building F_ Grading F-Drainage (-Elec F_Mech (-Plum CuvdCut L CuvdFRI Project Address (Not mailing address) 1- Flood f- Fire 7 Liq F_ Landslide f N/A Floor Suite No r --- F_ 2.2 S PO Nv _Fi e- Description o(ff Work Use F—ConstType F_ J f +t r, Of t m*\1,ec In ?,Cmc�eA Rer")OJL G.rt` i�c 1att � ._ #Stories_ #Units (if Res) I k z �et k f- Co,: A der • J New/Add SF�— Remodel SF g(� Garage/New/Add �- Fluation $ aterial/LaborF((),000 OWNER'S NAME Last Sul 1:Van First Owner's Address Owner's E-mail Address ._ ,z s Pof Avg _ �•1 K k City '-0 1Dc 4rI- ZipF__ A_ State �. q9A `( � 6 L S Telephone 30© - l `LS j APPLICANT'S NAME Last ' 1GkEISpY\ First AVSF„^ Applicant's Address Applicant's E-mail Address ln..� 5+ .. City ..._ State Lc Zip Q2�Q6 K Tel-LI4)_ ct(0-Z`18+i ARCHITECT/DESIGNER'S NAME Last First _....... Lic. No. �— Architect/Designer's Address Architect/Designer's E-mail Address - -- - - City State � Zip� Telephone� ENGINEER'S NAME Last First Lic No.F— Engineer's Address Engineer's E-mail Address City State F Zip �— TelephoneL— CONTRACTOR'S NAME/COMPANY . . Sj/V LicNo 43L,;Itlers Inc. I'�2 -2 Class Contractor's Address Contractor's E-mailAddress ^^ �� p �, j ,/�ew`per't H✓L SG6-i" G sk-, City �VS }th State FZ Zip �Zj�jJ Telephonek-j t, ,) -I I 10 `t1 SETBACKS REAR SETBACKS FRONT PERMIT NO. I/ OW baa - dy % 3 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $