HomeMy WebLinkAboutX2022-1536 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °��a....
F-Building F- Grading F-Drainage j-Elec F-Mech Plum Cu Yd Cut Cu Yd Fill I
Project Address (Not mailing address) F7 Flood F_ Fire r Liq j Landslide I N/A Floor Suite No
Do Wt
Description of Work
Use F—ConstType
# Stories 2 # Units (if Res)[
=P l�
Valuation $
Material/Labor1*17.1000
New/Add SF� Remodel 5F1
Garage/New/Add
cixi %,, v First i
OWNER'S NAME Last ��U�L/
1P
O[wnees Address
Owner's E-mail Address
lot !1 C
City y State
Zip I (�'1� Telephone' q(a9�
APPLICANTS NAME Last 1-T1-A
First ()1A/Ctr
Applicants Address
Applicant's E-mail Address
I-L3ft`LCr-WC3`te/ �a
i�L1SS,u`iCI}
City .. f�/ C Pr. �,-Ny+i�- State ; 44-
Zip 1jqj`7 o .S-- Telephone -] IJ.f. � `g (i'? j
ARCHITECT/DESIGNER'S NAME Last i
First � Lic. No. �
Architect(Designer's Address
Architect(Designer's E-mail Address
city State j
Zip Telephone
ENGINEER'S NAME Last I X I A C)
First { 6)1 i rV (, Lic. No.' S
Engineer's Address
Engineer's E-mail Address
City S �} �N State j (fp,
Zip ! Ra.7CK Telephone, ��(? ( [ 6
CONTRACTOR'SNAME/COMPANY j N S�� p_� � Lic No. �il 744(7 ClassiFC
�IVS
Contractor's Address
Contractor's E-mail Address
City S v ra Cl .. State I
Zip 1: q 9_7 0S Telephone' -7'4 ;V I E3 1
SETBACKS REAR SETBACKS FRONT
PERMIT NO. "!�C/ 1%
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USF 70NF OMIM, nORACK r ran
Of nni ruonv er�eo 0