HomeMy WebLinkAboutX2022-0377 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_ Grading rDrainage r Elec r—Mech r Plum CuvdCut F CuvdFill
Address (Not mailing address) F Flood F_ Fire F_Liq F_ Landslide F_N/A Floor Suite No
�iAC,k�K/ 4`(/1 W2(( k)ni il��/L rA.le/I//n
Work
New/Add SF F_
Remodel SFF Garage/New/Add
Use ConstType F
# StoriesF_ # Units (if Res)[_
Valuation $ Q
Material/Labor X IS
OWNER'S NAME Last— First \ O 2_ i
Owner's Address Owner's E-mail Address
City �` �� f� C� /(� _0,/ I/ -State Zip C4 Telephone
APPLICANT'S NAME Last I\� Z First
Applicant's Address Applicant's E-mail Address
�7
ZD�S Sl�l areY4 1'/ty)6A9,0U/6►1C_S7j0''IP 0/�
City /� rn State Zip �2_7`� Telephone /�,22, 7CCi
ARCH ITECT/DESIGNER'S�NAME LastA_V/\q ( 1 First N6�—y Lic. No. C�� D
ArchitectlDesigner's Address Architect/Designees E-mail Address
3 242 VM Ckj s e to ►-gccz f►°o c iretY r' c
City i 1/�UL(D C�*p) State A Zip q21,qq/
77 Telephone c %1i� —Cpgo
ENGINEER'S NAME Last *V C to ( First Q►' 1�00' Lic. No.F—
Engineer's Address Engineer's E-mail Address
City���� /�� State Zip Telephone G�q)
CONTRACTOR'S NAME/COMPANY - S ` C { n� Ir f Lic. No. G�l'�/ {�/J�ClassI
(i0 J I ai— ��/1
Contractor's Address Contractor's E-mail Address _
f`�✓� ��Sf �i,SS 5 b0
Ci / State �I ��L� Zi Tele hon%, / /� C
tY�lL1/ p p ✓[O q
SETBACKS REAR
SETBACKS FRONT V OU'- 0311 PERMIT NO.
SETBACKSLEFT
SETBACKS RIGHT
PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $