HomeMy WebLinkAboutX2022-0768 - Permit ApplicationPrint Foam Worksheet for Combo Building & Solar Permit Application
[; Comm'I j✓esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building rGrading E.-Drainage ❑Elec rMech CPlum cuvdcutF CuvdFill
Project Address (Not mailii
3901 MAQYCU 5 Ave
Description of Work
DAJ 1mR (;�UCV Vila
New/Add SF ti/
OWNER'S NAME
i [ Flood [ Fire f— Liq r- Landslide F `N/A
N tW por % 13tigQ)
i-
cat t_F + 90 LF
Floor Suite No
E7 [7—
Use F ConstType
G I I J # StoriesF # Units (if Res)r_
Remodel SF I
Valuation $
Garage/New/Add F Material/Labor E57 L 7
Last
Owner's Address
l y 53 w e pa 01y
city N ew CLO Y_— k_scac .1' state C A
APPLICANT'S NAME Last
Applicant's Address
city -- State
ARCHITECT/DESIGNER'S NAME
First
Owner's E-mail Address
ZIP ql i (n(n Telephone rOl, CM.q-) rn n
First
Applicant's E-mail Address
Zip p Telephoned
Last CW\ k •} `('� First
Architect/Designer's Address
yIS 36 Fin Sup+e Z2
city New QYV State CA
Lic. No.
Architect/Designer's E-mail Address
b'rQdSiM� i ViayCht teC i-� Wfil� LOIM
Zip Z W 6 Telephone q Gj
ENGINEER'S NAME Last 1 First
t' `hU� i Lic. No.�—�
Engineer's Address
I -I'
City -- 5--� v y � � State G
Engineer's E-mail Address
Zip QZ l Telephohe
CONTRACTOR'S NAME/COMPANY Lrc No. Class
Contractor's Address
501 30 {V, S— , /k---
City IN t elocCt l_ state
SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
iSabella "_ �On �kLtvV ,G,V1
Zip Telephone (ti({t� n -b 46 C p 0"
PERMIT NO. ZZ b7 %Q
PLAN CHECK NO. A171 ,v _-0377
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PLAN CHECK FEES $