HomeMy WebLinkAboutX2022-0370 - Permit ApplicationPrint Foam Worksheet for Combo Building $ Solar Permit Application
[—; Comm'I Residential City of Newport Beach - Building Division ga-L2 63
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building r;Grading ["Drainage EElec r"Mech F7Plum CuvdCut � CuvdFillF__
Project Address (Not mailing address) r' Flood r- Fire F Liq [ Landslide EN/AFloor Suite No
Description of Work
Use C ConstType C
# StoriesF # Units (if Res)F_
Valuation $
New/Add SF Remodel SF � Garage/New/Add Material/Labor �zavts_+
OWNER'S NAME Last I First
Owner's Address
City �, f State
APPLICANT'S NAME Last
Applicant's Address
City , j�j State C/p
Owner's E-mail Address
r-A-t- t- ir-, e (9iYl.9 iZ .Gveti/
Zip Telephon 5W 1135/_05jr
First'
Applicant's E-mail Address
DwD.
zip
ARCHITECT/DESIGNER'S NAME Last _ First Lit. No.
Architect/Designees Address Architect/Designer's E-mail Address
City �— State � Zip � Telephoner,
ENGINEER'S NAME Last First Lic. No.�—'
Engineer's Address Engineer's E-mail Address
City State �— Zip �— TelephoneF777—
CONTRACTOR'S NAME/COMPANY / / /� Lic. No. ��G3 Class F
Contractor's Address Contractor's E-mail Address
City 112see,2s G _ State Zip 4zsO3 Telephon �F Z77 — -
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
PERMIT NO.
SETBACKS RIGHT
PLAN CHECK NO.
DEVELOPMENT NO
v . �
-C%C •` PLAN CHECK FEES $
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