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HomeMy WebLinkAboutX2022-0120 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application F Comm'I F Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F_Buildingj- Grading F-Drainage r Elec Mech r Plum Cu Yd Cut F Cu Yd Fill F Project Address (Plot mailing address) I- Flood Fire Liq j- Landslide FN/A Floor Suite No F_ F_ V V V( Description of Work Use Const Type # Stories # Units (if Res) Val o Z ©0C� eri /Labor / New/Add SF�— Remodel SF Garage/New/Add �— OWNER'S NAME Last 1 First 07y Owner's Address Owner's E-mail Address// City p State rl ` Zip Telephone 1 h , APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State F ZIP Telephone ARCHITECT/DESIGNER'S NAME Last F First Lic. No. Architect/Designer's Address Arch itect/Designer's E-mail Address City State Zip I Telephoned ENGINEER'S NAME Last �— First Lic. No.� Engineer's Address Engineer's E-mail Address City State �— Zip Telephoned CONTRACTOR'S NAME/COMPANY Lic. No.��Zy % Class Contractor's Address Contractor's E-mail Ad ress 4 / r. f1 q r'L City �)1 � ; �� State Zip Cjol-/ Telephone el- TS1 , SETBACKS REAR SETBACKS FRONT PERMIT NO. e G) I L SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. j � �� � ZU USE ZONE DEVELOPMENT NO PLAN CHECK FEES $