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HomeMy WebLinkAboutX2022-0496 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application �_R ° F_ Comm'I F- Residential City of Newport Beach - Building Division X 2022- 04 Ci CO o d NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ,11� •l rBuilding r Grading F -Drainage r Elec r Mech r—Plum Cu Yd cut Cu Yd Fill F Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F- Landslide F_N/A Floor Suite No Description of Work Use 'Const Type 121 �� L� # StoriesF # Units (if Res) - - Valuation I� OOQ Material/Cabo New/Add SFF— Remodel SF Garag F_ a/New/Add � OWNER'S NAME Last� /AN j � First Owner's Address Owner's E-mail Address City ( State— Zip Telephone - APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State ... Zip r. Telephoned _.... __ ARCHITECT/DESIGNER'S NAME Last l Jb DJQ6 First r, Lic. No. Architect/Designer's Address Architect/Designner'ss�E-mail Address es�s /�j� ��j-- City NS� 1 State MA7 Zip 5 Telephone F 1Last ENGINEER'S NAME First —', Lic No.F— Engineer's Address Engineer's E-mail Address City State —, Zip F_ Telephone n Lic. No. 6T 35 2', Class CONTRACTOR'S NAME/COMPANY - j v v 4� ,{ / ® sI u� Of JYContractor's Contractor's Address E-mail Address city State F_ Zip F— Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. t-% USE ZONE DEVELOPMENT NO PLAN CHECK FEES $