HomeMy WebLinkAboutX2022-1487 - Permit ApplicationPrint Form Worksheet for Combo Building &'Solar Permit €Applilcetion QCity of Newport Beach -Building Division
Comm]Residential. NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F Building F_ Grading F-Drainage F_ Elec F_Mech
F- Plum CuvdCut F CuvdFill F
Project Address (Not mailing address) I- Flood
f%tlICI✓� Lt74y_.
F_ Fire F_ Liq r Landslide FN/A Floor Suite No
Description of Work
Use Const Type
# Stories #Units (if Res)
Valuation $ I
Material/Labor)
New/Add SFF Remodel SFF_ Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City �JPMZ �eA E ..... gpafa l7 State �,4
Zip 9��bC2 Telephone .Z�7 �_Ac07I
APPLICANT'S NAME First Last �„k cs 6_en7.J. -..-
Applicant's Address
Applicant's E-mail Address
yoy -
city CC7 i Q esld - State CA_... _
Zip g2&Z7 Telephone iy9 w9/-9ozo
ARCHITECT/DESIGNER'S NAME Last
First Lic. No
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City State
Zip I Telephone
ENGINEER'S NAME Last
—
First Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State
Zip Telephone
CONTRACTOR'S NAME/COMPANY /p8 ` �� Lic No. o � t 5 g Z Class
u' _Td )
Contractor's Address
671/- _ /Gf� S7
Contractor's E-mail Address
City COS Eye State E'er
Zip- 926 e 7 Telephone `9 y 9- (,g,_ cq o,
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $