HomeMy WebLinkAboutXR2022-3142 - Permit ApplicationPrint Form
Worksheet for Combo Building& Solar Perm] + Application
Comm'I F_ Residential -Building Division City of Newport Beach
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NOTE: PLAN CHECK FEES DUE AT TIME
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F,-Building r- Grading F-Drainage VEIec Mech
F_ Plum CU Yd C.t Cu Yd Fill
Project Address (Not mailing address) Flood r- Fire F_ Liq F- Landslide F_N/A Floor Suite No
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Description of Work
Use —
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4pluation $
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New/Add SFF Remodel SF Garage/New) if
OWNER'S NAME
First F
Owner's Address
Owner's E-mail Address
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City FkOG _fbCT State F
Zip Telephone[
APPLICANT'S NAME Last 126 (G First
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Applicants Address
Applicant's E-mail Address
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City I Qj�,4j.4 S State FC7
Zip F� Telephone F��q�
ARCHITECT/DESIGNER'S NAME Last( First _N_ Lic. No.
F
Architect/Designer's Address
Architect/Designer's E-mail Address
06
City State
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Zip Telephone[ 90-!j_-S-173-/W
ENGINEER'S NAME Last F_
First Lic. No.
Engineers Address
Engineer's E-mail Address
City State
Zip Telephone[
CONTRACTOR'S NAME/COMPANY
Lic. No. Class F7
Contractor's Address
Contractors E-mail Address
City State F_
Zip r Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X12 ZOZ-a
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 1i?fq-,700,0 -
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $