HomeMy WebLinkAboutX2022-0792 - Permit Application (3)sion
NOTE: PLAN CHECK FEES D�liTITIIIME OFSUBMITTAL
C1
Print Form Worksheet for Combo Building& Solar Permit Application
)X Comm'I IX Residential City of Newportg
rX`Building jX Grading FXDrainage (x Ele jX Mech
r Plu Cu Yd CutF_ Cu Yd Fill
Project Address (Not mailing
address) Ix Flood
Fx_ Fire CX Liq rX Landslide IXN/A Floor Suite No
Description of Work
Use ConstType�
# Stories # Units (if Res)F
L)N -
Vf
MaterialL$abor j/
New/AddSFI Remodel SFF- Garage/New/Add a/New/Add
OWNER'S N�A:E Last
rApy- �-T
First d(M [7tQZ.Owner's
7 '
Owner's E-mail Address
City C �►�'f � 't24-�
State
Zip(124�n Teleplhond&k?) -7:�f 2
APPLICANT'S NAM Last
(55p{Sp�_
First
Applica UL dress
Applicant's E-mail Address
City �_---
State F
Zip F Telephoned
ARCHITECT/DESIGNER'S NAME
Last First Lic. No. t;'.,Zi§94�
Architect/Designer's Address
°
Architect/Desn is E-mail Address
Ait�fLL_
VVIPe co%',
City I LONG F,( I
State �`
Zip r_ Telephon sD^10_f ^
ENGINEER'S NAME Last
First I� Lic. No.1
Engineer's Address
Engineer's E-mail Address
City �
State ��
Zip �� TelephoneF_
CONTRACTOR'S NAME/COMPANY EYtfVnCvNkuClass
s
Contractor's Address
Contractor's E-mail Address
58Sri A41 PL �•7��
c`CScgneK E/12 'ACY 1 NaN, <oM
City q�9L 3M A
State <A
Zip c,) z g Telephoned
7,7
SETBACKS REAR
SETBACKS FRONT
PERMIT NO,
SETBACKS LEFT
SETBACKS RIGHT
t ,
PLAN CHECK NO.
111
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $