HomeMy WebLinkAboutXC2022-1909 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm'I ( Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building r Grading
j—Drainage j—Elec F_Mech Plum CuYdCut s CuYdFill s
Project Address (Not mailing address) C Flood F Fire r7 Liq r- Landslide (-N/A Floor Suite No
zlo� U--)
Description of Work
Use Const Type
# Storiess # Units (if Res)s
New/Add SF�--
Remodel SF�— Garage/New/Add �—
Valuation $
Material/Labor
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City F—
State �—ZiP r— Telephoned----
---------..._____
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State �— Zip — Telephone�—
ARCHITECT/DESIGNER'S NAME Last First F Lic. F——
No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip � Telephone
ENGINEER'S NAME
Last First Lic No.
Engineer's Address
Engineer's E-mail Address
City
State �® Zip �— Telephoned--
CONTRACTOR'S NAME/COMPANY ar / /H ,vtsIf i�o.F— Class
Contractor's Address 36 Qp , CC�}� p C Svc 3 0:�
Contractor's
E-mail Address
City I / D }^
State (2 ZiP 9OSi�3 Telephone 7/4J>]0
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. C 2 Ocv�
`� !
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $