HomeMy WebLinkAboutPV2022-108 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application?EWPoRO
Comm I sidential City of Newport Beach -Building DivisionNIU11
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_, Flood r Fire r Liq F_ Landslide F_,N/A Floor Suite No
Description of Work
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Valuation'/OOD
Material/Labor
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OWNER'S NAME Last00Sso First ' s
Owners Address Owner's E-mail Address
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APPLICANT'S NAME Last First
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Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First��, Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip __. Telephoned
ENGINEER'S NAME Last �/l pv�V"ttlotq First Lic. No. GGey! G 3
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY - Lic No. %O?�I Zrd Class Cf4
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Contractor's A"ddress/ Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. PV zozz
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 109 2022
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USE ZONE DEVELOPMENT NO 0074' 62S3 PLAN CHECK FEES $