HomeMy WebLinkAboutX2022-0290 - Permit Application-Print FoWorksheet for Combo Building $ Solar Permit Application
r' Comm'I [ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing addii
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Description of Work j pj
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OWNER'S NAME Last ,6o First
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Suite No
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# StoriesF_ # Units (if Res)F
Valuation$ ��/
Material/Labor L' `'
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last
Applicant's Address
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City I [OUXIA0 Nk(AVt
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City
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State
First
Applicant's E-mail Address
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Last A 11vn First O htt.i Lic. No. 1 p Lly
Architect/Designers E-mail Address
State Zip �. Telephoner
ENGINEER'S NAME Last ( j' First Lic. No.�
Engineers Address Engineers E-mail Address
City State Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY rLic. No. t� 1`5 � vj Class C- �1 LetY�c�t� c�,�.t
Contractors Address Contractors E-mail Address
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SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. ?CZCD�//�Z —[�ze-
PLAN CHECK NO. 02,6 _ . _
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $