HomeMy WebLinkAboutX2022-0611 - Permit ApplicationPrint Form Worksheet for Combo Building $ Solar Permit Application
r Comm'I residential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DLIP AT TIME nF sl IanAITTAi
,wilding FGrading j-Drainage F_Elec rMech F-plum cuydCut cuvdFill
6'
Project Address (Not mailing address) I— Flood j- Fire F- Li Landslide I -N/A Floor Suite No
71,n E-lorhor is/�>7� or 3 F_ r
Description of Work
Use F—ConstType
# Stories7 # Units (if Res)F—
Valuation $
Material/Labor 1315/OOb -
New/Add SF F — Remodel SF Z 2 5 Garage/New/Add �-
OWNER'S NAME Last /17 7
5 /hVyS7+� 7-L-2- First
Owner's Address
Owner's E-mail Address
b p
City /�/G/v fj�� �G�� State rf�-- Zip F" TelephoneF—
APPLICANT'S NAME Last 4?f-fLf First
Applicant's Address
Applicant's E-mail Address
L 7�
!�(d/µ7 V//C ,IVCJ17fjlai/aPL°+/�.C�rv. ]
CityLGfG%/�Ol7Cl /�G jls State �- Zip l y224r,, "r3' Telephone -2«i gZ5- /a3 ?2
ARCHITECT/DESIGNER'S NAME Last Rd 5 f Al,�-_A f L�-)-Ost —
d C�� e 4 U Lic. No. C_ 3.69" 17
ArchitectlDesigneerr's Address Architect/Designer's E-mail
Address
L
�oJ3 � !✓ Gf ' �!G! !J - SLJ�G� /a� U� i rGh �7% B%_5r r (� / G G S• ��
City % ✓ V f 1% G State EZ011F Zip QJ Telephone 2/!' - 771- �G/S
ENGINEER'S NAME Last First F Lic. No.F_
Engineer's Address Engineer's E-mail Address
City State F_ Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY J/VGA 3u/ I /G Lic. No. Z%91,jpZI Class
Contractor's Address Contractor's E-mail Address V 3au /$ 11 3/Z 3
City FLG�u y}� �CS State �- Zip �iZG ?j Telephone 7l
S �/ 9z5 �f3_�) ?
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Osi1- tQ?A
USE ZONE hF\/FI nDAACAIT Ain ill 42
PLAN CHECK FEES $ 4 8