HomeMy WebLinkAboutX2022-0709 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
[, Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
'Building � , Grading F-Drainage F-Elec j", Mech Plum
r Cu Yd Cut Cu Yd Filll
Project Address (Not mailin
of Work
rl Flood r Fir Liq r Landslide
New/Add SFs—Remodel SFF Garage/New/Add
OWNER'S NAME Last
Owner's Address
City
APPLICANT'S NAME Last
First
Owner's E-mail Address
State I , Zip
Applicant's Address
City State
- - - s s--
ARCH ITECT/DESIGNER'S NAME
rN/A Floor Suite No
Use F7Const Type F
# Storiess # Units (if Res)s
Valuation $
Material/Labor
First.._- /A)4ErVI—
Applicant's E-mail Address
Zip
Telephone %iy 225 _�- S
Last First—' �-
Architect/Designer's Address Architect/Designer's E-mail Address
City State
ZIp�-- Telephone
ENGINEER'S NAME Last
First �— Lic No.F_----
- - Engineer's Address
Address - - ---
Engineer's E-mail Address
_. __..
City -- -...
State F777Zip �_ Telephone[,
CONTRACTOR'SNAME/COMPANY
I' LrTtc F/ _�t�� Lic. No. �6 p S�2T} Class_
--
Contractor's Address - --
Contractor's E-mail Address
City--- 1�1'�.✓aVvi I ✓%Cv5-i �s
State TelephoneZip
� I70"7ns/01�
�_Yz. 1pS,r
'.-.. _.____.._....._..._-.
2Sz s�
SETBACKS REAR SETBACKS FRONT
PERMIT NO. XZQ�f�-
SETBACKS LEFT SETBACKS RIGHT y�
PLAN CHECK NO. L06
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $