HomeMy WebLinkAboutX2022-0953 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application of�SAW
F_ Comm'I r Residential
City of Newport Beach - Building Division F
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c„oar"
Muilding F_ Grading F-Drainage XElec WMech
Plum Cu vd cutF Cu Yd Fill F
Project Address (Not mailing address) F_ Flood
i° Fire F_ Liq F_ Landslide rN/A Floor Suite No
I ? ( �" De- t)ed,,�_ `�UV21 ce F__
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Description of Work
Use 1� 7l d Const Type
I�'Di�UO
44
c�� VldtrL —
# StoriesF (if Res)FT
���� F I t 4
n#,Units
Valuation YLQ
Material/Labor
bor C(,Yf
�n��" �� g
New/Add SF Remodel SF Garage/New/Add a/New/Add �—
OWNER'S NAME Last
First �f
Owner's Address
Owner's E-mail Address
?��' ✓ �Q _ �VV?? C2
lM , of �o oq L a oneQol J�u, r� S ,Cork
City13State �,�
Zip 01 t--�O�7 Telephone `Z44 276D -1 ? 1 i
APPLICANT'S NAME Last ow) ev de>N� First
Applicant's Address
Applicant's E-mail Address
C-V �(� /�
City FG1 I- G f, State CG
Zip ,,;, TTelephone /F 6q ,ge/6s
ARCHITECT/D IGNER'S NAME Last �5-2, f0-if Q C7
a �t/J�ll[ F41 I Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City State F_
Zip F_ Telephoned
ENGINEER'S NAME Last _Uvd- Vt el
First F Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY GLWL 6-,m 0,,-, G f- f) Lic. No.Class
Contractor's Address
Contractor's E-mail Address 3 7-7 Ll 5 a
a t? (, t
yap , � crc @ (c yvi vt e a l Co w
City 1 v rcl�.00 CII"� � State C -
Zip q TelephoneF
SETBACKS REAR SETBACKS FRONT
PERMIT NO. AqW
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USEZONE DEVELOPMENT NO
PLAN CHECK FEES $