HomeMy WebLinkAboutX2022-0008 - Permit Application1. Print Form I Worksheet for Combo Building & Solar Permit Application VVRE
F_Comm'I (- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) f Flood r Fire r Liq F e j-N/A Floor Suite No
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Description of Work
Use Const Type F
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# Storiesr— # Units (if Res)F
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New/Add SFF— Remodel SF — Garage/New/Add �—
Valuation
Material/Laa bor
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OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State F- ZIP F_ Telephone�—
APPLICANT'S NAME Last N i,Vil'(i klaky�
First
Applica//�n//��t'sAddress rr //ll Applicant's Address
ry/E-mail
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City State
_ Zip F— Telephone
ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State F ZIP �— Telephoner
ENGINEER'S NAME Last F® First �® Lic. NoF_
Engineer's Address Engineer's E-mail Address
City State F Zip F— TelephoneF—
CONTRACTOR'S NAME/COMPANY 'ci Llljii Lic. No. Class
Contractor's Address Contractor's E-mail Address
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City ���� U(� ( State zip (, % Telephone��
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $