HomeMy WebLinkAboutXC2022-1907 - Permit ApplicationPrint Form
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building [ Grading F-Drainage [Elec �Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) _ Flood F_ Fire F- Liiq Landslide f N/A Floor Suite No
%F
/
Description of Work
Use F_ Const Type
# StoriesF # Units (if Res)F—
New/AddSF� Remodel5F� Garage/New/Addy—
Valuation G
Material/Labor
OWNER'S NAME Last G yt/l ,e I � IL First
Owner's Address Owner's E-mail Address
N.� ��l t�l�zN13..� - 1��11 CCSsls,ay�p r
City Iv , (j. State
- L C--Zip 9%r6._-Telephone 7lKY57R7�-1
APPLICANT'S NAME Last mac( c� uL First
Applicant's Address Applicant's E-mail Address
--s�ssr�s V Ct3.Co�
City .—� _� — State C � Zip ct l- 6 3 Telephone 5-7-Cj 7c�
ARCHITECT/DESIGNER'S NAME Last [me_First CT �l S
✓r Lic. No. L - 3
Architect/Designer's Address Architect/Designees E-mail Address
City �j State F/- Zip M 66 3 Telephone �r�� !v0 L105r1
ENGINEER'S NAME Last First F Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State �® Zip F Telephone S
CONTRACTOR'S NAME/COMPANY P Ic %ter vr, Lic. No. Class
Contractor's Address Contractor's E-mail Address
I,�-76t( ILoc.I4ft V, b1.c` fmor,__�Y@ PLw„+tk w-IicunSNvc�tFyh-now
City f t State I c- / ` Zlp -�l T6 !g Telephone Gt q HH 5-p-_(, -7 Lt v
SETBACKS REAR SETBACKS FRONT PERMIT NO. XG�LZ — C [6 f
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $