HomeMy WebLinkAboutX2022-0312 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application
r Comm1 [ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
New/Add SFF— Remodel SF ge/New/Add
OWNER'S NAME
Last e __" 4_rA. First -& 11R-4-z
F-Building [ Grading F-Drainage [ Elec 1-Mech F- Plum Cu
Project Address
1 l� � R„
Cu Yd Fill
r Flood F_ Fire i- Liq r Landslide F_N/A Floor Suite No
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Description of Work Use ConstType
# StoriesF # Units (if Res),
S
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Owner's Address Owner's E-mail Address
cityP _ 1 State 1 �1 r Zip -- -- Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
_ I � IYlE- _ i7c�t_ LL`'
City - State G' Zip q6Z, Telephone 2 �3 "1 2� S`�
ARCHITECT/DESIGNER'S NAME Last First
Lic. No.
Architect/Designer's Address Architect/Designees E-mail Address
i
- — -
City State �— Zip Telephone
ENGINEER'S NAME
Address
City
Last First
Engineers E-mail Address
State F Zip F
Lic. No.F—
TelephoneF77777
CONTRACTOR'S NAME/COMPANY , K Lic. No.� 6B Class
avldContractors Address Contractor's E-mail Address
_&�ir
City State Zip Telephone
l_ ay�c rdb -- C 2-13
SETBACKS REAR SETBACKS FRONT PERMIT NO. )CZt5 /&, — Q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. C�Z46—
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $