HomeMy WebLinkAboutX2022-0939 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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City of Newport Beach - Building Division
(- Comm'[ r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Fo...�
F-Building r Grading
r-'Drainage r- Elec r" Mech I- Plum CuYdCut CuydFill -F
Project Address (Not mailing address r Flood r Fire (- Liq r Lan tide r-N/A Floor Suite No
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Descri ion of Wor
Use F Const Type FV'3
# Stories # Units (if Res)F—
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Valuation $
New/Add SF�
Remodel SF Garage/New/Add �
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Material/Labor 1
OWNER'S NAME
Last u First
Owner's Address
Owner's E-mail Address
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City
State F Zip F_'. Telephoned'
APPLICANT'S NAME
Last WTfy�_e_ First r 7-7 far ao2
Applicant's Address
Applicant's E-mail Address
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City State Zip Telephone���
ARCHITECT/DESIGNER'S NAME Last First �r�9T�
v" Lic No.
Architect/Designees Address
Architect/Designers E-mail Address
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State � Zip � Telephone
ENGINEER'S NAME
Last (�q% First6 eq „ — Lic No.F—
Engineers Address
Ennyg�ineer's E-mail Address
City
State J Zip Telephone Lr1 -' z5?e_/Q /
CONTRACTOR'S NAME/COMPANY Lic. No. I Class
Contractor's Address
Contractor's E-mail Address
City State F_ Zip F— Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 2O LZ OCAIS
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. dV7� V Z
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $