HomeMy WebLinkAboutPV2022-0354 - Permit ApplicationL Print Form _1 Workslheet for Combo Building & Solar Permit Application
F_ Comm'I ( Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT
f—Building F Grading
TAL V C L
F—Drainage F— Elec 7 Mech Plum l� l�
Cu Yd Cut l Cu Yd Fill
Project Address (NOt mailing address) T FloodF_ Fire F_ Liq r Landslide f N/A Floor Suite No
Description of Work
Use r ConstType F
# StoriesF—# Units (if Res)F—
Valuation $
Material/Labor
New/Add SFf ---
Remodel SF�— Garage/New/Add �—
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
City
State �— Zip Telephone—
ARCHITECT/DESIGNER'S NAME Last First �— Lic. �—
ArchitecUDesigner's Address
No.
Architect/Designer's E-mail Address
City
_ --
State F_ Zip �— Telephoner
ENGINEER'S NAME
Last �c c First Lic No.
Engineer's Address
Engineer's E-mail Address
City [ State F_ Zip F— Telephone
CONTRACTOR'S NAME/COMPANY Lic. No.
E11h�CeµwC 'uc�. j 905- Class
Contractor's Address c
c Contractor's E-mail Address
city State F_ Zip �— TelephoneF�
SETBACKS REAR
SETBACKS FRONT PERMIT NO
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO, Zp22--
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $