HomeMy WebLinkAboutX2022-0681 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application
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F Comm'I r Residential City of Newport Beach - Building Division
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F—Building (—Grading F-Drainage F_Elec r—Mech "Plum Cu Yd Cut Cu Yd Filll
Project Address (Not mailing address) F Flood F_ Fire F_ Liq F_ Landslide [N/A Floor Suite No
Description of Work
Use F Const Type
# StoriesF # Units (if Res)
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_C�NA
Valuation $
Material/Labor
New/Add SF�— Remodel SF
Garage/New/Add F
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City _ State
Zip F— Telephone F_
NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State �—
Zip Telephone—
ARCHITECT/DESIGNER'S NAME Last 5 First T" K4 Lic. No. .+jtl vU
Architect/Designer's Address
Architect/Designer's E-mail Address
_
City State F_
ZIP F— Telephoner
ENGINEER'S NAME Last F®
First F_ Lic. No.
Engineer's Address
Engineer's E-mail Address
City State F_
Zip [_ Telephoner
COiyTRACTOR'S NAME/COMPANY
Lic No. F— Class �—
Contractor's Address
Contractor's E-mail Address
City State F
zip F TelephoneF�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.y2I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 1 Oil -1ip2 j
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $