HomeMy WebLinkAboutX2022-1483 - Permit ApplicationL Print Form 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 F_Grading r-Drainage F_Elec F_Mech F-plumCu Yd Cutl Cu Yd Fill
Project Address (Not retailing address) I- Flood f Fire F- Liq r- Landslide F_N/A Floor Suite No
30 S J C �'✓/ 5 /`p er , _ i e�-,o -
Description of Work
Use F_ ConstType
/
# StoriesF_ # Units (if Res)1_
New/Add SF Remodel SF / Garage/New/Add
f��
Valuation$
Material/Labor r Gamma �G,
OWNER'SNAME Last First
Owner's Address Owner's E-mail Address
City State �— Zip — Telephone
APPLICANTS NAME Last First
Applicant's Address ��2 fyl� S Applicant's E-mail Address
City State Zip F TelephoneF—
ARCHITECT/DESIGNER'S NAME Last First-
- - Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip F— Telephonel
ENGINEER'S NAME Last First Lic. No. F_
Engineers Address Engineers E-mail Address
_ - --
City [ State F_ Zip TelephoneF_
CONTRACTOR'S NAME/COMPANY lrG Lic. No. -8 /
«a�r� �5 Class
Contractors Address Contractor's E-mail Address Brt3o�Z�G�E�
-
City �fr� �Cl47 a State Zip Z-f or Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �3lo�S-2UZL
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $