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HomeMy WebLinkAboutPV2022-034 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit A plication oo Comm'I F_Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding r Grading j—Drainage F_Elec F_ Mech r Plum cuvdCut F Cu Yd Fill F Project Address (Not mailing address) f- Flood f— Fire F_ Liq r Landslide [_N/A Floor Suite No Description of Work V l' a Use F Const Type F # Stories #Units (if Res) 16 to' ULM n Valuation$ New/Add SFF__ Remodel SFF— Garage/New/Add F— Material/Labor OWNER'S NAME Last First Owner's Address Owner's E-mail Address City State F Zip F—Telephone— APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State r Zip F—, Telephoned ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designees E-mail Address City State F_ Zip F—' Telephone ENGINEER'S NAME Last First f Lic. NoT Engineer's Address Engineer's E-mail Address City _ State F_ Zip F— Telephoner CONTRACTOR'S NAME/COMPANY ( D Lic. No.F? W(-6 Class Contractor's Address Contractor's E-mail Address 2A'5L H City 7yv rt State F Zip Wt4� Telephone 'E &j - q SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $