HomeMy WebLinkAboutPV2022-104 - Permit Application (3)Frint Form Works eet for Combo Building & Solar Permit Application
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V _ _r City of Newport Beach - Building Division t& vl/4 L-400
r Comm'I Residential t.
ential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL A)694
`Building [_ Grading F—Drainage rElec FMech [® Plum CuvdCut r— CuvdFill
Project Address (Not mailing address) L_ Flood [_ Fire I Liq F- Landslide
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I —N/A Floor
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Suite No
Description of Work Use F—Const Type
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� i I A -I- i_ � #Stories #Units (if Res)
Valuation $
New/Add SF Remodel SF Garage/New/Add Material/Labor
OWNER'S NAME Last First
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY SLic. No. 1033 3 9d Class G-10
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Contractor's Address
City_ �1.�..., State I C,-
SETBACKS REAR
SETBACKS FRONT
Address
IZC4!�_k_.f►s►.�.��sUnveov, 51 �
Zip 4IS/U`? Telephone CT51 As -14�w
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $