HomeMy WebLinkAboutX2022-0988 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application o�aEWP°R�
City of Newport Beach - Building Division ` 1 '�`' ;��
Comm'] Residential ° z
,-----NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
C9CIFOR� P
f-Building L... Grading F,,Drainage r•Elec Mech f`" Plum CuYdCutF CuYdFill
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq r Landslide rN/A Floor Suite No
FA F7A 1 i1- �0,c-
Description of Work IU
Use ConstType F
# Stories ,)., # Units (if Res)[—
Valuation $
New/Add SF�� Remodel SFj�'� Garage/New/Add
Material/Labor
OWNER'S NAME Last'; First
Owner's Address Owner's E-mail Address
City I t0 eW State C 0 ! Zip Telephone r -�
APPLICANT'S NAME Last �G�,� FirstTeo
Applicant's Address Applicant's E-mail Address
City i� e ,( ` .} c�Cl� State Ff (A Zip 1 ��6� 1 Telephone 2',6r
ARCHITECT/DESIGNER'S NAME Last �rc� ,-y�� First Lic. No.
Architect/Designer's Address Arch itect/Designer's E-mail Address
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City S State C 1� Zip I C465'.:e Telephone q SCE
ENGINEER'S NAME Last First Lic. Not-7
Engineer's Address Engineer's E-mail Address
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City v'�(t <'` State {� Zi r(� �(- q�`� ^ 7a y 1
(� l 1 S. . .... _.. - C' p �l 6 3 Telephone
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CONTRACTOR'S NAMEXOMPANY Lic. No, �"(i�)3'j Classr?
Contractor's Address Contractor's E-mail Address
City �f + by � Q C �� State �� Zi �- TelephoneI s i 0
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 0916 --Too 2
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ !�,' , N1