HomeMy WebLinkAboutX2022-0829 - Permit Application (2)Worksheet for Combo Building & Solar Permit Application
[7 Comm'I Residential 0 7,Y,20v&ity of Newport Beach - building Division &-Z)
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[_—,Building r Grading
Project Address (It
of Work
Krainage f— Elec rMech 7 Plum cu Yd Cut Cu Yd Fill
address) F- Flood Fire r Liq r LandslideN/A Floor Suite No
cr zhA
r I - F77 F77
Use F7 Const Type F 7
# StoriesF7 # Units (if Res[7
. .. ........ ------------- - -------- r
Valuation $
Remodel SF Garage/New/Add Material/La
New/Add SFF77
bor
77
OWNER'S NAME Last - A First
Owners Address Owner's E-mail Address
I r
— ---------
city State ZIP f—, TelephoneFqq T2qa
APPLICANT'S NAME Last �7 First
Applicants Address Applicants E-mail Address
n
City [1 state Telephone_7
ARCHITECT/DESIGNER'S NAME Last
Address
City
ENGINEER'S NAME Last
Address
City State–T-- Zip
7
FirstF77777
E-mail Address
Lic. No.F7777
OR'S NAME/COMPANY Lic. No. Class r;7
Address Contractor's E-mail Address
Ji F
t eF77 Zip i Telephone
C,
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $