HomeMy WebLinkAboutXR2022-2823 - Permit ApplicationL Peirit Form ___) Works'heet for Combo Building & Solar Permit Application Us—.,
Comm'I Residential City of Newport Beach - Building Division 'NA �ja- � ��NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITI�"A`L
Building Grading Drainage Elec j" Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f- Flood (— Fire I` Liq F_ Landslide f N/A Floor Suite No
Description of Work Use Const Type F—
# StoriesF # Units (if Res)[
........ _ _ _..____. _..__.______.._..__.
(� Valuation $ ,1
New/Add SF Remodel SF�— Garage/New/Add I - Material/Labor U C/
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State F
Zip[ —
Telephoned_
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
ENGINEER'S NAME Last First F Lic. No.
Engineer's Address Engineer's E-mail Address
City F State Zip Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class
Contractor's Address Contractor's E-mail Address
city
SETBACKS REAR
SETBACKS LEFT
USE ZONE
State F Zip Telephone
SETBACKS FRONT PERMIT NO, A 7-3
SETBACKS RIGHT PLAN CHECK NO. &vZo2,z_j,gq-
DEVELOPMENT NO
PLAN CHECK FEES $