HomeMy WebLinkAboutXR2022-3288 - Permit ApplicationL_Lrihtl`orm__j Worksheet for Combo Building & Solar Permit Application
j- Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building f-Grading F-Drainage 1'3�Elec (-Mech j-DI
Ict Address
Ption of Work
- - -_ um Cu Yd Cut Cu Yd Fill
(Not mailing address) f- Flood j- Fire Liq F_ Landslide [N/A Floor
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ZZ B 'x 1S to � ARI&E
F
New/Add SF�— � Remodel SF— Garage/New/Add "
OWNER'S NAME Last
Owner's Address
City
First SvSai%
Owner's E-mail Address
State �— Zip
APPLICANT'S NAME Last
Applicant's Address
City �GG.G , ��1 State �-
-- - .. _- ---- G--
ARCHITECT/DESIGNER'S NAME Last
Address
City
Suite No
Use r Const Type
# StoriesF # Units (if Res)F
abor AS0,oe -
First
Applicant's E-mail Address
fz-2 ��izo z$DD C rl,-7ve
ZiP Telephone T/ tz� ,f_
First �— Lic. No. �-
Architect/Designer's E-mail Address
-- -- ---- -----
State �— Zip Telephone
ENGINEER'S NAME Last 777 First
-- — - — -- Lic. No. 7y5-7
- -- ---
Engineer's Address Engineer's E-mail Address
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City �/ ri �� State I�4 Zi p D� Tele hone Q ®o
CONTRACTOR'S NAME/COMPANY
.4 LL , ( 'Lic. No. j(�(��Class�
Contractor's Address
City ��/� // State
- F
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
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ZiP �W50 Telephone
PERMITNO. �C�L;`�(JL�-37j�
PLAN CHECK No. pCZFSLZ-3l [�'�
PLAN CHECK FEES $ \_ I