HomeMy WebLinkAboutXC2022-2069 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application IW7
"°qrot `�Residential City of Newport Beach - Building Division 1"Comm'[ r, NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o ,
Y
46uilding ❑Grading [Drainage [�_).Elec ,�}Mech Plum euvdCut CuvdFill
�I
Project Address (Not mailing address) ❑ Flood ❑ Fire Liq ❑Landslide ❑N/A Floor Suite No
of Work IUse l /[/R nstType
# Stories # Units (if Res)C7
Valuation $
New/Add SFF Remodel SF[ Garage/New/Add Material/La �1/
OWNER'S NAME Last �{,� dN��t:` First j
Owner's Address Owner's E-mail Address
[tI ffJ GV it
City fZtij \ k State (r` Zip Telephone • 70.- . +1 t/
APPLICANT'S NAME Last `fj%" First
Applicant's Address
LM
City State UT-1 Zip
Applicant's E-mail Address
?I'
NCB
ARCHITECTIDESIGNER'SNAME Last h .C�� First hl�. Lic.No. (J 12
ArchitectlDesigner's Address Architect/Designers E-mail Address
City - -- t r / � State L'� _ Zip r � -o TelephoneMd
ENGINEER'S NAME Last FirstLIc.No.F_ 1
Engineer's Address Engineer's E-mail Address
— -- i
City J State C—� Zip Telephone —I
CONTRACTOR'S NAME/COMPANY
Contractors Address
Lic.No.i (' Class
Contractor's E-mail Address
i
City State—� ZiP Telephone j
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO _ PLAN CHECK FEES $