HomeMy WebLinkAboutXR2022-1993 - Permit ApplicationJnt Form Worksheet for Combo Building & Solar Permit Application Rm
r— Comml r Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
/'Building r-Grading r-Drainage r-Elec �Mech r-Plum Cu YdcutF— Cu Yd Fill F_
/Project
Address (Not mailing address) r- Flood r Fire r- Liq F_ Landslide N/A Floor Suite No
Description of Work
Use ConstType F
^vI�IL
h KIEw ��� ��
# Stories # Units (if Resf
New/Add SF�— RemodelSFFIV45— Garage/New/Add—
Valuation $10
Material/Labo•
OWNER'S NAME Last n0`ib 'El�sa�—� First �p�y✓j
wner's Address
Owner's E-mail Address
ZGII jLLU��1l�E• �N/E
city State �� Zip Gf�p Tele hone Gj
P t Z
APPLICANT'S NAME Last First M `
Glv,vlJi%��� om/ D
Applicant's Address Applicant's E-mail Address
City N State
Zip -_.._ �+ �2{o�it7 Telephone_J1�Z7g-2lgf
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip [= Telephones —
ENGINEER'S NAME LastA
MAV2F%20_- -_ - First LicNo.�IGGS�f�oo/S
Engineer's Address Engineer's E-mail Address
City State sin: Zip Telephone 5w- om /27g
CONTRACTOR'S NAME/COMPANY f Lic No. F— Class
6WN�lz
Contractor's Address Contractor's E-mail Address
City State F_ Zip Telephones
SETBACKS REAR SETBACKS FRONT PERMIT NO. CA2022-• 1g9�j3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Regjo72-1283
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $