HomeMy WebLinkAboutX2022-1772 - Permit ApplicationPrint Form
�_ I 9NorksMeet for Combo Building &Solar Permit Application
F Comm'I j- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r-Building F_ Grading F-Drainage r Elec F_Mech F' Plum CuYdCut r—
CuYdFill
Project Address (Not mailing address) F_ Flood F Fire i— Liq r Landslide F_N/A Floor Suite No
F
Description of Work
Use Const Type F
# Storiesr— # Units (if Res)r—
. .........................
New/Add SFr-- Remodel SFr— Valuatio
Garage/New/Add �- Material/La or 5
OWNER'S NAME y Last First L i
Owner's Address V
Owner's E-mail Address
City State F
zip Telephone
APPLICANT'S NAME Last Or,
Applicant's Address Applicant's E-mail Address
City State... F—_ Zip [— Telephoned_—.
ARCHITECT/DESIGNER'S NAME Last
JL(/� First Lic. No. I
Architect/Designer's Address ArchitectIDesigner's E-mail Address
City State F Zip I Telephone —
ENGINEER'S NAME Last
hn{'(wy, First l<0N Lic.No.r_-----
Engineer's Address Engineer's E-mail Add
City State I— Zip I Telephoned ------
CONTRACTOR'S NAME/COMPANY `1 Lic. No.
735'ly) I Class
Contractor's Address Contractor's E-mail Address
M 7 jO TotTIN #1(p
City State Zip Telephone
7 1 `f 33G>
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0.
USE ZONE
IlF1/FI r'1PAnc'nrr nin _