HomeMy WebLinkAboutXR2022-3063 - Permit Application_Print Fom____ Worksheet for Combo Building & Solar Permit Applicatilon z o
F Comm1 f- Residential City of Newport Beach - Building Division 2z
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_ Grading F-.Drainage F_ Elec F_ Mech F- Plum Cu Yd Cut Cu Yd Fill
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Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ LaFN/A Floor Suite No
Description of Work
Use F—ConstType F_
StoriesF— # Units (if Res)F—
New/Add SFF_ kemodelSFI Garage/New/Add
Valuation $
Material/Labor
OWNER'S NAME Last
Owner's Address Owner's E-mail Address
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City 14�q:."67—L State Zip F_ Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City state Zip Telephone I Lq
ARCHITECT/DESIGNER'S NAME Last FT Lic. No.FZ
Architect/Designer's Address Architect/Designer's E-mail Address
City state I Zip Telephone CIP
ENGINEER'S NAME Last F—First F_ Lic. No.
E ngineer's Address Engineer E-mail Address
City F State Zip Telaph-(Yn�—
CONTRACTOR'S NAME/COMPANY IC V)C)L_SCrr_j T�, _-,0711c�- Lic. No. Class
Contractor's Address Contractor's E-mail Address
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City State Zip Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO L/yaA&f
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $