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HomeMy WebLinkAboutX2022-0266 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division XolCk?�- ©oti�b (xComm'I Residential NOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building (— Grading (Drainage jyElec hZ,Mech Plum Cu Yd cutI cu Yd Fill Project Address Al Description of Work of mailing address) I- Flood (+ Fire r Liq r Landslide vim. d 14 4 64 4 New/Add SFF— Remodel SF 77� FN/A Floor FdTF Use lc-11 tfi —Const Type Suite No # Stories �� # Units (if Res)F_ Valuation $ Garage/New/Add [� Material/Labor - OWNER'S NAME Last ��Z�j� �[�"( First owner's Address Owner's E-mail Address City �� �✓�' State ( 1ac ZipTelephone[— APPLICANT'S NAME Last f First Applicant's Address Applicant's E-mail Address City F State Zip "111j Telephone ' ARCHITECT/DESIGNER'S NAME Last ��iL� First �� Lic. No. �W��C� Architect/Designer's Address Architect/Designer's E-mail Address t City State LlC\ Zip G�"' �! TelephoneF- ENGINEER'S NAME Last First Lic. No f Engineer's Address Engineer's E-mail Address City State F_ Zip �� Telephoned CONTRACTOR'S NAME/COMPANY Lic. No. 351 (q � Class c.� Contractor's E-mail Address �[ -(- _ ^2 e 2Z Contractor's Address City State Zip Telephoned�I. SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT PERMIT NO. 1)Cz1v&/6-- PLAN CHECK NO. I USE ZONE DEVELOPMENT NO PLAN CHECK FEES $