HomeMy WebLinkAboutF2022-0352 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application �=
F_ Comm'I F_ Residential City of Newport Beach - Building Division F
NOTE, PLAN CHECK FFFR ni r: AT TIK= no ci iDAAIIn
F-Building j- Grading F-Drainage F_ Elec F_Mach j- Plum Cu vd Cut r Cu Yd Fill F
Project Address (Not mailing address) F_ Flood r Fire F7 Liq r Landslide FN/A�Fll000r Suite No
Description of Work
Use � ConstType
DV--r' k.-� j-, St.,. I', Ile C
# StoriesF # Units (if Res)
Valuation $ 8r $
Material/Labor
New/Add SF �! 9 ° `� Remodel SF� Garage/New/Add
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City � State �— Zip F_ TelephoneF_
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— Zip F Telephone—
ARCHITECT/DESIGNER'S NAME Last First F_
Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
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city ---
- - State F Zip F TelephoneF
ENGINEER'S NAME Last F_First F_ Lic. NoF_
Engineer's Address Engineer's E-mail Address
City State �® ZipF TelephoneF_
CONTRACTOR'S NAME/COMPANY �r4•y r �a� v_.,, +Ibn Zac, LIC.NO. /d37ga:1 Class Z,It_
Contractor's Address Contractor's E-mail Address
C c�gic�C''v.yr.tC-.n.,4-
City Mon ZJ✓ I ,q- State C/i Zip k tO t(, Telephone 426 3 S7 4/vyS
SETBACKS REAR SETBACKS FRONT PERMIT NO. '�Z/L. tp545Z
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. PC.2-o22 - t7
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $