HomeMy WebLinkAboutXC2022-1952 - Permit ApplicationL Print Form J Worksheet for Combo Building & Solar Permit Application
F_ Comm] F_ Residential City of Newport Beach - Building Division byM,�� I&
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
ullding [7 Grading F—Drainage F_ Elec F_ Mech F— Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ Flood f— Fire f— Liq Landslide F_N/A Floor Suite No
Description of Work
Use Const Type F_
# Stories? # Units (if Res)-
............ . - ...... .... ... .... ...... .
Valuation $
Material/Labor
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last C� First
Owner's Address Owner's E-mail Address
C,
City State zip C�9 ('2S Telephone
APPLICANT'S NAME Lastl Firsti.
Applicant's Address Applicant's E-mail Address
c.
---------- - -
City State Zip Telephone ic1 6 -::7 a 2
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last First F Lic, No.1,
Engineer's Address Engineer's E-mail Address
City State F_ zip Telephonel
CONTRACTOR'S NAME/COMPANY lLic. No. Class
Contractor's Address Contractor's E-mail Address
City State F7F-Zip Telephone FJDA_Z bq --a
SETBACKS REAR SETBACKS FRONT PERMIT N 0.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO 215;, P,�A(�IECK FEES $