HomeMy WebLinkAboutXR2022-2650 - Permit ApplicationPrint Form
Worksheet for Combo Building & Solar Permit Applicatio PO
Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL,,,,('
F713uilding F Grading F—Drainage F_ Elec F_ Mech Plum Cu Yd C,t F Cu Yd Fill F
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use ___&Const Type
Stories[ Units (if Res)Fy—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
city State A 01L.T.
zip Telephone
Applicant's Address Applicant's E-mail Address
City State Telephone
F Zip
ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No.
Architect/Designer's Address Arch itect/Designer's E-mail Address
F7
city State F Zip F_ Telephone
Engineer's Address Engineer's E-mail Address
City � G�� |Zipi Telephone|
N&ME/�OMPANY |
CONTRACTOR'S| N« Lic��| {]ao�
|
' /
Contractor's Address
Contractor's E-mail Address
"'�v | State Zip | Telephone
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO'
PLAN CHECK NaVj=::::