HomeMy WebLinkAboutX2022-0597 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r,AbiIding r Grading rDrainage r�c r Mech r Plum CuvdCut F CuYdFill F
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
�6I VIA LIDO. SOvO F_ �—
Description of Work
Use F ConstType
# Stories #Units (if Res)
ELEvt__t—rLD12 Sr{4
UANCFL-yVQgrt�tit
New/Add SFF Remodel SFF— Garage/New/Add F_
Valuation $
Material/Labor
OWNER'S NAME Last taA First 5-1E 1?_:,
Owner's Address Owner's E-mail Address
Vik LIct—_:�
City �% �W> �p�e State (f4 zip q-z�g Telephone ��
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City �— State F_ Zip F Telephoned
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip F Telephone
ENGINEER'S NAME Last First 7— Lic. No.F--
Engineer's Address Engineer's E-mail Address
City �— State F— Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY_ r_—p� LiNo.T�/ jL
Contractor's Address Contractor's E-mail Address
`f Z I Wie V4 P-urtneL
City V — State I �. _ Zip ¢ �� Telephone C� yq
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $