HomeMy WebLinkAboutPV2022-194 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application IMM
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[—Building FGrading F—Drainage [Elec rMech F_Plum cuvdcutF CuYdFill F
Project Address (Not mailing address) 17 Flood F_ Fire [ Liq j- Landslide FN/A Floor Suite No
Description of Work Use F ConstType
# Stories # Units (if Res)
Valuation $
New/Add F77777 Remodel SFF—Garage/New/Add F—Material/Labor
OWNER'S NAME Last
Owner's Address
City
APPLICANT'S NAME
Address
Last
First
Owner's E-mail Address
State F Zip F77777 TelephoneF—
City State F
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City State
ENGINEER'S NAME Last
Engineer's Address
City State F!
CONTRACTOR'S NAME/COMPANY
First
Applicant's E-mail Address
Zip F Telephone—
First E77:777 Lic. No.
Architect/Designees E-mail Address
Zip F Telephone
First F Lic No.F
Engineer's E-mail Address
Zip TelephoneF—
Lic. No. F_— Class
Contractor's Address Contractor's E-mail Address
City State F— Zip F Telephonel
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. A \
PLAN CHECK NO.
PLAN CHECK FEES $