HomeMy WebLinkAboutXR2022-2446 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q_4�1F Comml �Residential City of Newport Beach - Building Division`` NOTE: PLAN CHECK FEES DUF AT TIMF nF ci ianniTToi
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Project Address (Not mailing address) I— Flood r Fire F_ Liq F_ Landslide F_N/A Floor Suite
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Description of Work "N t
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Use ConstType
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# Stories # Units (if Res)F
Valuation $
Material/Labor '� S
Remodel SF
New/Add SF biG2 Zvi L
Garage/New/Add a/New/Add
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OWNER'S NAME Last v ((.�f7PaT_t>
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First K-fArVi
Owner's Address
Owner's E-mail Address
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City State �—
Zip 9 �a Telephone 4-�,� �`
APPLICANT'S NAME Last i�u Sio#,`14+J
First `
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Applicant's Address
Applicant's E-mail Address
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City -� State F�,
Zip FY 7 Telephone 6 k I y� g
41
ARCHITECCY/ ESIGNEW' ME Last First
Lic. No. �—
Architect/Designers Address
Architect/Designers E-mail Address
City s k �E State
Zip 7Z.(j2-:7 Telephone • �_
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1 1 rLiic..No._
ENGINEER'S NAME Last Y,lA
First Q("Gr
Engineer's Address 4,Q IV,
Engineer's E-mail Address
City '54wrk-koi— State �—
Zip q`L-1 - Telephone Os/�
CONTRACTOR'S NAME/COMPANY
Lic.No.l�-6 Class
Contractor's Address
Contractor's E-mail Address
City State F—
' A
Zip F— Telephoned— �� 1
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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