HomeMy WebLinkAboutX2022-0858 - Permit Application520110 Worksheet for Combo Building & Solar Permit X Application
(-, Comm'I r Residential City of Newport Beach - Building Division U2,% - og�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(- Building r_1 Grading (-Drainage j-' Elec
Project Address (Not mailing
IN _WMM M.
of Work
F Mech r Plum Cu Yd
F- Flood Fire r Liq [M Landslide
Cu Yd Fill F
[_-,,NIA Floor Suite No
Use F7 F77
# Stories , # Units (if Resf
Valuation $
New/AddSFF77777 Remodel SFF Garage/New/Add Material/Labor F
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
.......... .... ...... _ _.... .....
City State F777 Zip �— Telephoned,
NAME Last
Applicant's Address
City State
First
Applicant's E-mail Address
Telephone
Zip F_d—i
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
i
City State
Architect/Designer's E-mail Address
Zip Telephoned
i
ENGINEER'S NAME Last First€ Lic. No.�
Engineer's Address
..---- -_ _.._-- ,. ...._ ._,
City State
Engineer's E-mail Address
........ ... _ _... _.;.
Zip Telephone—E
CONTRACTOR'S NAME/COMPANY S �eJ �4C ; Lic. No. %B U ` Class
Contractor's Address Contractor's E-mail Address
�O La ------- -_.------- ------------ O �L f hr4k, e
City Cm f State Zip G(�(2) Telephone 949-6`�� S6S
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK
USE ZONE
DEVELOPMENT NO
PLAN CHECK