HomeMy WebLinkAboutX2022-1497 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application zEW�a>
r Comm I Residential City of Newport Beach - Building Division
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NOTE: PLAN CHECK FFFS Dl IF AT 71nnc nF ci ianniTTei
Building r' Grading
j--Drainage r Elec j Mech r Plum CuvdCut F_ CuvdFill
Project Address (Not mailing address) r Flood r Fire r" Liq r` Landslide I -N/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)s
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New/Add SFr
Valuation $ 6C( 0
Remodel SF Garage/New/Add �- Material/Labor ��
OWNER'S NAME
First
Last _ / 6 ( /° F�Ilf F%�I`�
Owner's Address
Owner's E-mail Address
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City N/ p(/� ��./% l __.. State C�� Zip �iTelephone 'X* 7�r_.c
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APPLICANT'S NAME
Last ��� S First
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Applicant's Address
Applicant's E-mail Address
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City Jl K; �lr
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State C Zip �/l .��/ Telephone 7� ti- 'i 7 VV6
ARCHITECT/DESIGNER'S NAME
Last /-'
l�YD7�! f�', First F
% Lic No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
State Zip �— Telephone—
....... ___._......
ENGINEER'S NAME
Last First Lic. No.F—
Engineer's Address
Engineers E-mail Address
City
State �— Zip �— Telephone—
6NTRACTOR'SNAME/COMPANY
_ _ Lic. No.
Class l�elS 1pez1 r?
Contractor's Address
Contractor's E-mail Address
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City I C6)3j.4_\
State c-A Zip C__2GaZ7 Telephone q�/6/ &91-so20
SETBACKS REAR
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SETBACKS FRONT —0 PERMIT NO, X✓`-�(��j
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SETBACKS LEFT
SETBACKS RIGHT y PLAN CHECK NO. pygi/
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $