HomeMy WebLinkAboutX2022-0737 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application a 6�
City of Newport Beach - Building Division
Comm'I [Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building Grading
[Drainage EElec rMech F. Plum Cu vd cut Cu Yd Fill17
Project Address (Not mailing address) G Flood [ Fire [ Liq [ Landslide ❑N/A Floor Suite No
Description of Work '
Use F ConstType C
2 ' iJeCK 12r?4f S yG sF f �I�S
# StoriesF # Units (if Res)[_
174_11' .IAaa
Valuation $
Material/Labor 4r $ V d
New/Add SF �
Remodel SFF_ Garage/New/Add F_
OWNER'S NAME
Last first
Owner's Address
Owner's E-mail Address
City State F Zip � Telephoned
APPLICANTS NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State Zip TelephoneL_
ARCHITECT/DESIGNER'S NAME Last L First �� Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City
State F— Zip F_ Telephonel—
ENGINEER'S NAME
Last First F�— Lic. No.
Engineer's Address
Engineer's E-mail Address
City
city
State I Zip � Telephone
NAME/COMPANY Lic. No. F_ Class
Contractor's Address
Contractor's E-mail Address
City
State �— Zip F Telephoner
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PI GN rtHFCK PPPC C