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HomeMy WebLinkAboutX2022-0915 - Permit Application (2)Ptnt,Form Worksheet for Combo Building & Solar Per I Applicatio?m Comm'I C Residential City of Newport Beach -Building Div !Sion NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �<„o„r CBuilding C Grading [Drainage C Elec Mech C Plum cu yd cutF— Cu Yd Fin Project Address (Not mailing address) C Flood C Fire C Liq [7Landslide CN/A Floor Suite No Description of Work /1 7',l Use F7Const Type # Stories❑ # Units (if Res)F7 Valuation $ New/Add SF Remodel SF F77777 Garage/New/Add Material/Labor G (/ OWNER'S NAME Last yo r� I First I �/L/C I Owner's Address Owner's E-mail Address City `{*, State � Zip Telephon APPLICANT'S NAME Last e,417( /7”) First A A-1�) Applicant's Address Applicant's E-mail Address 41 City State Zip 22 Telephon v_d D1/j— ARCHITECT/DESIGNER'S NAME Last First F777-71 Lic. No. 1-7-71 Architect/Designer's Address Architect/Designer's E-mail Address City State Zip F7777 Telephoned ENGINEER'S NAME Last1-71 First Lic. No.� Engineer's Address Engineer's E-mail Address City I State Zip �— Telephone[= CONTRACTOR'S NAME/COMPANY h Lic. No. c Class 9 —317 Contractor's Address Contractor's E- ail Address e h City State v I—J Zip Telephone �Z SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PERMIT NO. PLAN CHECK NO. 0 c7 _ Qf PLAN CHECK FEES $