HomeMy WebLinkAboutXR2022-3054 - Permit ApplicationPrint Form I Worltsheet for Combo Building & Solar Permit Application �E�PoRa
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City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF Sl IRMITTAI
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Project Address (Not mailing address) C Flood j- Fire F- Liq i- Landslide F_N/A Floor Suite No
77 F_
Description of Work Use 17 Const Type
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# StorieOD # Units (if Res)r—
Valuatio $
New/Add SF�— Remodel SF�— Garage/New/Add �— Material aS
or �
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OWNER'SNAME Last First Owner's Address Owner's E-mail Address
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City_
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FI.tSY-'6�} State .-------
APPLICANT'S NAME Last p "First
Applicant's Address Applicant's E-mail Address
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ARCHITECT/ ES S NAME Last First F-
_`�-`...z'�_��'���---+++�YdO. - Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip �— Telephone[
ENGINEER'S NAME Last
�l't D - First D Lic. No.�
Engineer's Address Engineer's E-mail Address
City State Zip Telephoned —
CONTRACTOR'S NAMEKOMPANY Lic. No. �— ClassF_
Contractor's Address Contractor's E-mail Address
city StateF.
Zi Telephoned®
SETBACKS REAR SETBACKS FRONT PERMIT NO. kle2f%� �J6�j7
SETBACKSLEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHFCK FFFR R