HomeMy WebLinkAboutX2022-1048 - Permit ApplicationP�ir;t Form Worksheet for Combo Building $ Solar Per
F -i Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHE9K FEES DUE AT TIME OF SUB
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Address
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Cu Yd Cut ; Cu Yd Fill
r' Flood ❑ Fire r, Liq F.7 Landslide
New/AddSFF_______7 Remodel SFF�S, Garage/New/Add
OWNER'S NAME Last
Owner's Address
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City _� ��'P i7_����G.-�Y�-_-t`-
APPLICANT'S NAME Last
Applicant's Address
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State ^
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First
Owner's E-mail Address
MV
FWA Floor Suite No
Use I Const Type F-7
# StoriesFI # Units (if Res)[ J
Valuation $
Material/Labor i
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First
Applicant's E-mail Address
Zip Q b tO-� Telephone _ 1
ARCHITECT/DESIGNER'S NAME Last First �! Lic. No.
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Architect/Designees Address
City State
Architect/Designees E-mail Address
i
Zip i Telephoned -1
ENGINEER'S NAME Last i First F_Lic. No.F.—
Engineer's Address
City State F^
Engineer's E-mail Address
Zip F— Tele hone—I
CONTRACTOR'S NAME/COMPANYI Lic. No. g� �� Class
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Address Contractors E-mail Address
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State l Zip 11 �i 1111 Telephone �Z, l!1 �9�d 1
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. 1674 � 10Q S
PLAN CHECK NO. d961- Utt
PLAN CHECK FEES $