HomeMy WebLinkAboutXR2022-1858 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm] Residential City of Newport Beach - Building Division L a'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_ Grading Drainage F_ Bee r- Mech F- Plum CuvdCut s cuvdFill F
Project Address (Not mailing address) F_ Flood i- Fire F_ Liq F_ Landslide F_N/A Floor Suite No
I
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Description of Wo
Use s Const Type lip--ns�
# Stories # Units (if Res)
Valuation $ �n
Material/Labor
New/Add SF Remodel SFr— Garage/New/Add F
OWNER'S NAME Last 'j�� First
/Address
Owner's Address Owners E-mail
GOd f -
City i " jJ��fJi GLb state ��� Zip r Telephoner
- -- -
APPLICANT'SNAME Last j"� First
�mail
Applicant's Address Applicant's E Address
--y t LILG Gcy1���LaS'LtX 'G
City -�j`� ( State j��,,/'zipp Telephone�c/A 3�
ARCHITECT/DESIGNER'S NAME Last G`� First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City �— State �— Zip Telephoned— —
ENGINEER'S NAME,/ /Last First Lic.No.s
Engineer's Address Engineers E-mail Address
City State Zip I TelephoneJJ
CONTRACTOR'S NAME/COMPANY LicNo. 5�6 �`�C� Classy
Contractor's Address Contractor's E-mail Address
City State I Zip Telephones®
;ETBACKS REAR SETBACKS FRONT PERMIT NO.
:ETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
1SEZONE DEVELOPMENT NO PLAN CHECK FEES $