HomeMy WebLinkAboutPV2022-079 - Permit ApplicationWorksheet for Combo Building & Solar rerlrruL
Print Form � AL Z
City of Newport Building Divisio
Residential c E AT TIME OF SUB ITTAL
(- Comm', r NOTE- PLAN CHECK FEES DU cuvdFiu (�
ort ear', Plum caudat
Building rl Grading f -, Drainage r Mech r Landslide riN/A Floor Suite No
r' Not mailing address)rl Flood [-. Fire - I- �I
Ele
I
Project Address ( � -- -
-- Use
Const Type
Description of Work # StoriesFi # Units Cif Res)F,
---- - Valuation $ i
---- -_ Material/Labo
Garage/New/Add r
- _ i
New/Add SF�-i Remodel SF -
PPLICANT'S NAME Last
applicant's Address
�--- I State
ARCHITECT/DESIGNER'S NAME
Applicant's E-mail Address
i
_ ne -
Zip
- _ Telephone
First�ii Lic. No.
f --
Las _..___
is E-mail Address
i
Architect/Designer's Address
�JState
City --
ENGINEER'S NAME
Archdect/Designe
Telephone
Zip
Last
Engineer's Address ---
State j
Engineer's E-mail A re
Zip Telephone
i
Lic. No
Lic. No. Class
CONTRACTOR'S NAME/COMPANY Contractor's E-mail Address I✓ � 3 0 0A -
Contractor's Address -------'- '-� --
------------ - ---
-- Telephon
State e
Zip 7 -
�—, -
City
PERMIT NO.
SETBACKS REAR
SETBACKS FRONT -- PLAN CHECK NO.
��
S��
SETBACKS LEFT �SETBACKS RIGHT � PLAN CHECK FEES $
IUSEZONE
DEVELOPMENT NO