HomeMy WebLinkAboutX2022-1530 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F— Comm'] F— Residential City of Newport Beach - Building Division
NOTE; PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F Building (- Grading F-Drainage F-Elec (-Meth r Plum Cu Yd CutIF Cu Yd Fill F_
Project Address (Not mailing address) F7 Flood F- Fire F- Liq F- Landslide F-N/A Floor Suite No
Description of Work
Use F ConstType I
Stories # Units (if Res)F—
Valuation S
Material/Labor -{� I �t L
New/Add SFF Remodel SF I
Garage/New/Add f
OWNER'S NAME Last I C�I1�PpR`� First'
Owners Address
Owner's E-mail Address
o t TWA Z,<Spt 17 S. -T-
City N C� State Il..i
Zip 4 Telephone] °q4q ( l ! Ll
APPLICANT'S NAME Last
First ( I TP/G,Y,
Applicants Address
Applicant's E-mail Address
123t�2 C( tv�dN`6CSl
06tr,,S�MIT4� _rDLevc - N�ti
City (0 N State
7�p 19'l Telephone � /If S 9 1 I,-7J
I
ARCHITECT/DESIGNER'S NAME Last �-
First F
I Lic. No.
Architect/Designers Address
Architect/Designers E-mail Address
City State F_
Zip TelephoneF
ENGINEER'S NAME Last �/ )�
First ( i G, Lic. No. S;7
Engineers Address
Engineers E-mail Address
City _ (-vr-, o�- IDN State i
zip j 917 as Telephonei i / 4 t-62- D- -10
CONTRACTOR'S NAME/COMPANY i 6tJ� C "t4 ���� Lic. No. '�-7440 Class
Contractors Address
Contractors E-mail Address
I 13,4`L C(�,(V ON `kV ,
City S RN-m- �)Ca 1 _\_ State I _
Zip %- I (; Telephone 7 14-ST!�Ei 119
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
PERMIT NO. (N 7- I S�
CHECK
PLAN NO.
USF 70NF ncvo noncckfr nin
of nn, null, r=c c
ll\I\ 1i11L1i!\ 1 LLJ �