HomeMy WebLinkAboutX2022-0794 - Permit ApplicationPnni Form :'�_ Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
4pi�roy�
[Building F_, Grading [Drainage rElec rMech rPlum cu Yd cut Cu Yd Fill
r r r Project Address (Not mailing address) Flood r Fire Liq Landslide rN/A Floor Suite No
Description of Work
Use ConstType r --
# StoriesC # Units (if Res)F
hll
Valuation $
Material/Labo
New/Add SFRemodel SFGarage/New/Add
OWNER'S NAME Last First 'be=r L
Owner's Address Owner's E-mail Address
20l �I 4e__1 5— _7�( 700
City I SA -A fT4-1- lCJl, SCE State I Zip F_ TelephoneF_
APPLICANTS NAME Last First � ri�3
Applicant's Address Applicants E-mail Address
�p
City D State Zip Telephoned—!
ARCHITECT/DESIGNER'S NAME Last First eA^-R-' �_ Lic. No.
Architect/Designees E-mail Address
Architect/Designers ALddresss,�
,
City State Zip FCO Telephon s w {lM
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address Engineer's E-mail Address
City State F_Zip Telephone
CONTRACTOR'S NAME/COMPANY _ t15 k {�c.t ` Lic. No. I r Er Class
Contractors Address Contractor's E-mail Address
City F State Zip %SSA Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. c7'7(L( - ZCZ-Z
USE ZONE DEVELOPMENT NO b 2c22 _ /I I zq PLAN CHECK FEES $