HomeMy WebLinkAboutX2022-0502 - Permit ApplicationWorksheet for Combo Building
`gal City of Newport Beach- Building SolaDrvision
permit Application �NEW�R
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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i maiiing address Cu Yd Fill
1_1 Flood [ Fire I
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7�', Floor
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Work _i I
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1'r7 o ya�; y� Use Const Type
# Stories' #Units (if Res)
New/Add SF
- Remodel SF
Garage/New/Add Valuation $
OWNER'S NAME <
_ Material/Labor
Last ,
Owner's Address i First
V6 G Owner's :E-mail Address --- ---
city Ci Gl11-
State C (
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APPLICANT'S NAME p
Zi -1 X Zs Telephone
Last
Applicant's Address Y First _I
r Applicant's E-mail Address
City
State. I Zip
ARCHITECT/DESIGNER'S NAME Telephone
Last
Architect/Designer's Address �First , Lic. No.
Architect/Designer's E-mail
1' mail Address
city yV)�'-------'
State C
zip J
p
Tele hone
ENGINEER'S NAME
Last '
�- r
Engineer's Address. First?�
Lic. No.
Engineer's E-mail Address
city ' 1
State Zip
Telephone --I
CONTRACTOR'S NAME/COMPANY p e ��r� ` 7�
_. /
Contractor's Address vj
Lic: No. 'Class
Contra .
ctor's E-mailAddress
City
State1
I 7777
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Zip T ----_
elephone_
SETBACKS REAR --
SETBACKS FRONT
SETBACKS LEFT PERMIT NO. �ZoZZ--
SETBACKS RIGHT 66U 2
USE ZONE