HomeMy WebLinkAboutPV2022-022 - Permit Application (2)"v&rlrrs, I Worksheet for Combo Building & Solar Permit Application VF]Comm'I residential City of Newport Beach - Building Division PV2022�022 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building ❑Grading ❑Drainage ❑Elec ❑Meth ❑Plum CuvdeutC' CuvdFill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor J Suite No
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Description of Work
Use F7ConstType
# Stories❑ # Units (if Res(71
New/AddSFRemodel SF Garage/New/Add
OWNER'S NAME Last rD ?—'( NU -C � First
Owner's Address
Owner's E-mail Address
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City
APPLICANT'S NAME Last
State Gc� Zip
Applicant's Address
City State ! —
First
Applicant's E-mail AdWess
Zip F9 gTelephone
ARCHITECT/DESIGNER'S NAME Last First L� Lic. No.
Architect/Designer's Address
City I State
Architect/Designer's E-mail Address
Zip Telephoned
RMS
ENGINEER'S NAME Last First F77771 Lic. No.F77771
Engineer's Address Engineer's E-mail Address
City I State F-71 Zip F7_7 felephonel—
CONTRACTOR'S NAME/COMPANY\X o Lic. No. JO'j� t) ClassC Cc).
Contractor's Address
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City i c� State C�
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
(0_ak 71
Zip TelephoneJ� a8a gEc�
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $