HomeMy WebLinkAboutXR2022-2314 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I F_ Residential. City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SIIRMITTAI
F_Building rGrading j—Drainage F_Elec FMech F— Plum CuYdCut CuYdFill F_
Project Address (Not mailing address) F_ Flood F Fire j— Liq r Landslide `_N/A Floor Suite No
7' C,/kv c,/ulI F
Description of Work
Use Const Type
# Stories[— # Units (if Res)F—
Valuation $
Material/Labor FI$;000
New/Add SF�-- Remodel 5F�— Garage/New/Add �—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State F Zip �— Telephone�—
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— Zip — TelephoneF_
ARCHITECT/DESIGNER'S NAME Last First Lic No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— zip F— Telephone
ENGINEER'S NAME Last F® First F_ Lic. No. F_
Engineers Address Engineer's E-mail Address
City State zip Telephone
CONTRACTOR'S NAME/COMPANY Lic No. F— Class F_
Contractor's Address Contractor's E-mail Address
I
City � State F— Zip r---- Telephone[�
SETBACKS REAR SETBACKS FRONT PERMIT NO. 2(22 -
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO- 4 57 3 - Zo 2 t
USE ZONE DEVELOPMENT NO (�ZoLI—U3 �t PLAN CHECK FEES $