HomeMy WebLinkAboutX2022-0738 - Permit Application_Pijnt Foam Worksheet for Combo Building & Solar Permit Application
Comm'I [ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building r, Grading
Project Address I
�05- S ker i
[Drainage [ Elec [ Mech Plum
[ Flood [ Fire [ Li
Cu Yd Cute Cu Yd Fill
q [ Landslide [N/A
New/Add SFF__ Remodel SFE—Garage/New/Add r
OWNER'S NAME Last
Owner's Address
City
APPLICANTS NAME Last
First
Owner's E-mail Address
State I Zip
Applicant's Address
City State r
First
Floor Suite No
Use C ConstType F
# Storied # Units (if Res)F7
Valuation $ _
Material/Labor S� 0o C7
Applicants E-mail Address
Zip F_ TelephoneF_
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
City State
Architect/Designer's E-mail Address
Zip Telephoned
ENGINEER'S NAME Last First F___77 Lic. No.�
Engineer's Address
City State
Engineer's E-mail Address
Zip F TetephoneF
CONTRACTOR'S NAME/COMPANY Lic. NoT— Class
Contractors Address
City State
SETBACKS REAR
SETBACKS FRONT
Contractors E-mail Address
Zip �— TelephoneF—
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $