HomeMy WebLinkAboutXR2022-2057 - Permit ApplicationPrint Foam Worksheet for Combo Building & Solar Permit Application a.
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F Comm'I f� clential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
-Building j—Grading F-Drainage j—Elec r-Mech F-Plum CuYdCut
Cu Yd Fill I
Project Address (Not mailing address) i- Flood f Fire r- Liq r Landslide FN/Ar— Floor — Suite No
2&32- 1%k217 ��li��lU� l'' '174C, I
Description of Work
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�C) E%\ 1�rl q1b �)L V S 1 �� Use Const Type F
Storiesr— # Units (if Res)F_
New/Add SFF_ Remodel SF—Garage/New/Add �— Valuation iD 0C0
-Material/Labor
F2-2'6
Last
2�.3Z Z09_1� I NS-F First
Owner's E-mail Address
tV V/ isilck4 State -
Zip �0 Telephone
APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
City _ -
State Zip �— TelephoneF
ARCHITECT/DESIGNER'S NAME i
Last � First TkT: Lic. No. F —
Architect/Designer's Address Architect/Designer's E-mail Address
City State �—
-- ZIP �— Telephone
�—
ENGINEER'S NAME Last
First Lic No.F�
Engineer's Address Engineer's E-mail Address
City �® - State F ZIP _ Telephoned --
CONTRACTOR'S NAME/COMPANY
Lic. No. F� Class
Contractor's® Address Contractor's E-mail Address
7
city ZiP State �— F— Telephoned ZC23 o1,?? f
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ETBACKS FRONT
PERMITNO.I' iLy_
TBACKS RIGHT PLAN CHECK NO.
BL6 - n7VELOPMENT NO PLAN CHECK FEES $