HomeMy WebLinkAboutXR2022-2544 - Permit ApplicationPrint Form _ I Worksheet for Combo Building & Solar Permit Application �EWPoq>
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Comm� Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FFFR Ill IF AT T1nnc nc a110eA A
j`Building F_ Grading [—Drainage F_Elec F_Mech j`plum Cu vd cuts Cu vd Fills \J
Project Address (Not mailing address) 1- Flood F_ Fire r Liq F_ Landslide rN/A Floor Suite No
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Description of Work
Use � ConstType
# Stories # Units (if Res)F
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Valuation a �n
Material/Labor
New/Add SF Remodel SF [ Cj 777 C Garage/New/Add e/New/Add �—
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OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
City NSW /•-•';� /SP't(rf State r
G _ G• ZiP �z(y�. Telephone �.. s('C, -e'S-.xl
APPLICANT'S NAME Last J ]-h
First LYIfAb
Applicant's Address Applicant's E-mail Address
City PI1C/PwP1" State L Zipl ,�' Telephone �;2 g,� - ,12_y
ARCHITECT/DESIGNER'S NAME Last First F__ Lic. No. �—`—
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip F— Telephone[
ENGINEER'S NAME Last/G 7
First r/-j Lic. No.
Engineers Address Engineer's E-mail Address
City /�; State �— Zip Cf� 7�G" Telephone p "C
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CONTRACTOR'S NAME/COMPANY} ic. No. ���� Class�6
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Contractor's Address Contractor' E-mail Address
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City �,� t 1 S- State Fri/IT. zip �jJ Telephone Gt W C �� j J 3
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N1#1
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ ����•