HomeMy WebLinkAboutXR2022-2358 - Permit ApplicationI__ PrintForm j Worksheet for Combo Building & Solar Permit Application o�EW�ra
F- Comm] F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) C Flood F_ Fire F_ Liq F- Landslide CN/A Floor Suite No
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Description of Work'
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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City State
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ARCHITECT/DESIGNER'S NAME Last First I V U Lic. No. ` 5
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Engineer's Address
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CONTRACTOR'S NAME/COMPANY
Lic. No. �— Class
Contractor's Address
Contractor's E-mail Address
City State
Zip � TelephoneF_
SETBACKS REAR SETBACKS FRONT
PERMIT NO. Xp ZOZZ - S
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. EC70ZZ -2ZUZ
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $