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HomeMy WebLinkAboutX2022-0197 - Permit Application1 - Worksheet for Combo Building & Solar Permit Application F" Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding r Grading rDrainage r- Elec set Address of Work F-Mech Plum Cu Yd Cut Cu Yd Fill r Flood r Fire F- Liq F- Landslide rN/A Floor Suite N( I New/AddSFF— Remodel SF7 Garage/New/Addl OWNER'S NAME Last I N� WPD2"c (\SSS First Owners Address N © (k Owner's E-mail Address Use F Const Type F # Stories #Units (if Res )r abor19 t 5�7- 0 0 `,.i)l �Rl y $LC= t 1�— St city state j _ Zip � Telephone q 4 `j &'11 0 9 Ls - APPLICANT' S NAME Last FS -P&) j t� Applicant's Address 12 �t 6(- c WAD Cay - (R C( State r ER First I P N/O,US Applicanfs E-mail Address "SAA Zip C 'M D s Telephone'] l l♦- S-19 1191 ARCHITECT/DESIGNER'S NAME Last I First �— Lic. No. �— Architect/Designers Address Architect/Designers E-mai(Address City State [— Zip �— Telephone7— ENGINEER'S NAME Last I (a,® Engineers Address CityI.Spk v State CONTRACTOR'S NAMEICOMPANY Contractors Address M` 416A N ti o l%/ City( 5r",.Tv1Pt- .4tj First Q I (� Q& Lic. No.F!� g 9 Engineers E-mail Address e Zip l�� Telephone 1(i J35-) () f �si Lic. No. FL -17440 Contractors E-mail Address / State Zip�Telephone)E �1-2 1 i �I SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT PERMIT NO. 1 PLAN CHECK NO. USE ZONE DEVELOPMENT NO — PLAN CHECK FEES $