HomeMy WebLinkAboutXR2022-2143 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Rai
Comm'I F�esidential City of Newport Beach - Building Division
NOTE: PLAN C;HFr;K FFFC M IF nT Tleer nr ci IDKAI rAl
F_Building r-Grading [7Drainage r7Elec F_Mech F-Plum Cu Yd CutF_ Cu Yd Fill
Project Address (Not mailing address) [ Flood r Fire r-- Liq F_ Landslide FN/A Floor Suite No
Description of Work
Use F_ Const Type
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/>� L%/��F-C.I %� ! � /i ti' /'' 6� d �� �ICC>!C ` 'Ci; (`�.3 � 'i
# StoriesF # Units (if Res)F—
f
Valuation $
Material/Labor) 7
New/Add SF �— Remodel SF�— Garage/New/Add �
OWNER'SNAME Last First
Owner's Address Owner's E-mail Address
City ' „/r,e v ,'' t . ( 11i H/;' State FT
zip Telephone .',y
APPLICANT'S NAME Last �/� l%�l/ First �C[ S e,,v
Applicant's Address Applicant's E-mail Address
_"q_:!L
City `l(Gi✓1L`" Zip State (f ��/.. -Tele P honeJ C�
L ��_ 11
ARCHITECT/DESIGNER'S NAME ��aa
Last ��L t First �G{�Z �"t1 Lic. No.
_
ArchitectIDesigner's Address Architect/Designees E-mail Address
City State �— Zip F — Telephone %/� QD - q l ez
ENGINEER'S NAME Last q First F®
SC Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip[ Telephone
CONTRACTOR'S NAME/COMPANY �//� /�;' Lic. No. j,J Class ` 1`J
�l 'f� �f'Cc.GJ
Contractor's Address Contractor's E-mail Address
City %; / %` `';, State `✓.. ZiP r f `y Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. oZvzl `13
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.b 1r
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $