HomeMy WebLinkAboutX2022-1102 - Permit Application— Print Fo — Worksheet for Combo Building & Solar Permit Application oE�EWPoa@
f COmm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL _
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Project Address (Not mailing address f- Flood curdFm F
/� o ) Firer Liq r Landslide -N/A F Suite No
Description of Work P',
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# Stories # Units (if Res)F
New/Add SF (J' Remodel SF�— Valuation $
- - - -A Garage/New/Add �—
_ _ Material/Labor
OWNER'S NAME
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Owner's Address First
12q I 'Jll V9 Owner's E-mail Address
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APPLICANT'S NAME / - -� -- _
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Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
n 'nn l(� O First
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Archit ct/Designer's Address Lic. No. F —
dDv / Architect/Designer's E-mail Address
City State _ - — ------ Y/n Zip
Teleph
ENGINEER'S NAME LastM/
- iiy- ) First /_
Engineer's Address /_Lic. No.r—
Engineer's E-mail Address
City State �'
- - - ---
Zip --- ---
TelephoneF—
CONTRACTOR'S NAME/COMPANY {{ , P {i E S Lic. No. agV-1 Class
Contractor's Address
Zq Contractor's E-mail Address
City I Pusot State eA� Zip �- /- ) S Q lil_� ✓I�YYIeS
Telephone
LEA
KS REAR SETBACKS FRONT
S LEFT PERMIT NO. X % O�iL _ 1 I f
SETBACKS RIGHT t
E PLAN CHECK NO. I O 1� • 2021�
DEVELOPMENT NO PLAN CHECK FEES $