HomeMy WebLinkAboutX2022-1693 - Permit Application3
Print Form Worksheet for Combo Building & Solar Permit Application "°q>
F�Comm'I ,Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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E�13uilding ❑Grading [Drainage ❑Elec [,Meth [Plum cuYdCut F_ cuYdFill
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Project Address (Not mailing address) [, Flood ❑ Fire [ [N/A[I Floor Suite No
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Description of Work �iL/� -- �/J�s4/!b cS /Q2 AT?
UsConstType C
if Stories �l, #Units (if Res)FAli
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C New/Add SF Le P I S�,
J del SF '7�'L. ram. Garage/New/Add
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Valuation
Mater ial/Laa bor •`� �/v
OWNER'S NAME Last �%'�-4�%/�/' _ �j First j
Owner's Address ------Owner's E-mail Address--,/
City -----""- I State Zip �—' Telephoned
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APPLICANT'S NAME Last "( First
Applicant's Address Applicant's E-mail Address
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City &IseA � State A j Zip / �' � Telephone � —��cj -; e>.�!'.jL
ARCHITECT/DESIGNER'S NAME �7ZT—
Last / "A/ZJ ifC j Firsi /9 L/!� Lic. °y
Architect/Designer's Address Architect/Designer's E-mail Address
City I State zip L Telephone-
-- _ - —-----
ENGINEER'S NAME Last _ _ First Lic. No.
Engineer's Address Engineer's E-mail Address
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City State Zip Telephone
CONTRACTOR'S NAME/COMPANY , -=- Lic No. Fq Class
Contractor's Address Contractor's E-mail Address
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----- -- nlrlibti�r1etr�' '�1�?.�"1b>„L,-c..
City Chu 1C State /`i Zip FF�It,'_- Telephone`JSi-ZU /7/C
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N .
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $