HomeMy WebLinkAboutX2022-0697 - Permit Application (3)Worksheet for Combo Building & Solar Permit Application ",g' m
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Comm'] Residential City of Newport Beach -Building Division �a�a�'� V E
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL v G ea+
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Building ❑ Grading
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Project Address (Not mailing address) F.7, Flood [ Fire [, Liq [ Landslide CN/AFloor Suite No
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All '—•
Description of Work
Use C'! ConstType
# Stories[TZ # Units (if Res)s
New/Add SF
Remodel SF Gara a/New/Add
8 �
Valuation $
Material/Labor
OWNER'S NAME
Last �C first u
Owners Address
Owner's E-mail Address
644A
City ��
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State (r Zip ZS Telephone $1$
APPLICANT'S NAME
Last First ,.
Applicants Address
Applicant's E-mail Address
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City /` —:;: �Lb
State ZiP �17,65� Telephone �' N .1�
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designers Address
Architect/Designees E-mail Address
City �—
_ _ State Zip F_ Telephone
ENGINJFER+ AME
Last First Lic No.
Engineers Address
Engineers E-mail Address
City
State Zip F_ Telephones
CONTRACTOR'S NAME/COMPANY -f �LIb Lic. No. (dl Class
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Contractors Address
Contractors E-mail Address
City
State F__ Zip — -- Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK O. ! `r
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $