HomeMy WebLinkAboutX2022-1324 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application & WPo"o
F— Comm'] F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F—Drainage F_ Elec F_Mach F— Plum CuvdCut F CuYdFill F
Project Address (Not mailing address) C Flood r Fire r Liq r Landslide FN/A Floor Suite No
Description of Work nivWu S� _� ")v e k ,4WAc+4
Use F ConstType F
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# Stories #Units (if Res)
Valuatio
Material/Labor n f V
New/Add SF F__Remodel SF F— Garage/New/Add F__
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State �— Zip I ----Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— Zip [— Telephoned
ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No. F—
Architect/Designees Address Architect/Designer's E-mail Address
City State Zip TelephoneF—
ENGINEER'S NAME Last First Lic. NoF—
Engineer's Address Engineer's E-mail Address
City State Zip F Telephoned
CONTRACTOR'S NAME/COMPANY V%TA(LeL4. CJuS��°���cf' IA-c Lic. No. 4q;TL1- Class
Contractor's Address Contractor's E-mail Address
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6AAAUC.,C�00,
City l P S�,A State I "" Zip 'C�Z�62 Telephone Lkc\— 677-1r<lt
Z l 3 Z
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �7i%� --
USE ZONE DEVELOPMENT NO VZC /— C70�l D PLAN CHECK FEES $
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