HomeMy WebLinkAboutX2022-0533 - Permit ApplicationLt,"rorm ;'`, `I Worksheet for Combo Building $ Solar Permit Application
r; Comm'I L{_!�Residential City of Newport Beach -Building Division Un . OS33
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F-1 Grading rDrainage r Elec
Address
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Flood ❑ Fire r Liq n Landslide
Description of Work
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New/Add SFF—_777777] Remodel SFCI Garage/New/Add
OWNER'S NAME Last
Owner's Address
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City We_.wa� State
First
rN/A Floor Suite No j
L J
Use Const Type
# Stories # Units (if Res)C
Valuation
Material/Labor r
Owner's E-mail Address
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Zip
APPLICANT'S NAME Last First
Applicant's Address
City ---I State
Applicant's E-mail Address
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Zip Telephone �(,_( Z- 919W
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
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City State I Zip Telephoned
ENGINEER'S NAME LastFirst Lic. No. '7
- - --
Engineer's Address
City [C P 110 p p..__._ -- State
Engineer's E-mail Address
Zip d 2$0_2 I Telephone c/c
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CONTRACTOR'SNAME/COMPANY ; - Lic. No. 1021072_ Class �s37
Contractor's Address
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City�lV�C11I = _ State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
Contractor's E-mail Address
Zip —j3 j Telephone32�
x -4-0-4L - 0 33
PERMIT NO. n4At_7n�-
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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