HomeMy WebLinkAboutX2022-1820 - Permit ApplicationI_- Print Form I Worksheet for Combo Building & Solar Permit Application
Comm'I f- Residential City of Newport Beach - Building Divis'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r- Grading �Draina e
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Cu Yd Cuts Cu Yd Fill I
Project Address (Not mailing address 1- Flood ____ L
Fire [ Liq F_ Landslide [N/A Floor Suite No
Description of Work 70 u
R'F_ S UPS
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New/Add SFF — Remodel SF�—
OWNER'S NAME Last
Owner's Address
City
APPLICANT'S NAME Last
Applicant's Address
City
State
ARCHITECT/DESIGNER'S NAME
ArchitecUDesigner's Address
City
pp r� Use ConstTypes
# Storiess # Units (if Res)[ —
Valuation $
Garage/New/Add F_— Material/Labor �r ODd
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First
Owner's E-mail Address
I 7Zip
First
E
Applicant's E-mail Address
- -- —
ZIP �—' Telephone
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La First TE^
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Lic. No. •, ;-E
Architect/Designer's E-mail Address
State Zip Telephon
ENGINEER'S NAME Last First __ - N4N Lic. No q 15�
Engineer's Address - -
Engineer's E-mail Address
City
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State — -
Zip �— Telephone
CONTRACTOR'S NAME/COMPANY r
Lic. No. L --
Class
Contractor's Address -
Contractor's E-mail Address
City
State �— Zip Telephone
SETBACKS REAR SETBACKS FRONT YO
�_ PERMIT NO, /\G Q�
SETBACKS LEFT SETBACKS RIGHT c�
PLAN CHECK NO. ' . z0Z 4z
USE ZONE DEVELOPMENT NO )UZI- G586 PLAN CHECK FEES $