HomeMy WebLinkAboutX2022-0233 - Permit Application. -Pont Form:. Worksheet for Combo Building $ Solar Permit Application
a.
C Comm'I [ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building G Grading [Drainage EElec FMech F7 Plum CuydcutF CuvdFill C
Project Address (Not mailing address) C' Flood [ Fire [ Liq r Landslide I_N/A Floor Suite No
of Work
New/AW SF[7:�; RemodelSFF—
OWNER'S NAME . Last
Garage/New/Add
First
Owners Address
Owner's E-mail Address
APPLICANT'S NAME Last
First
Use CI ConstType F
# StoriesC �# Units (if Res
)C
Applicant's Address Applicant's E-mail Address
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City State Zip F— Telephone
ARCHITECT/DESIGNER'S NAME Last
First Lit. No.
Architect/Designees Address Architect/Designer's E-mail Address
City State Zip Telephonew/�g
ENGINEER'S NAME Last First/Lic. No. 51
Engineer's Address
� 77>> Engineer's E-mail Address
City �1���(�<� State FZA777Zip Telephone C� j cfE
CONTRACTOR'S NAME/COMPANY Lli /1 — ' � /� 1 Lic. No. � Class
Contractor's Address /� Contractors E-mail Address
City State F Zip Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. �" �P
PLAN CHECK NO.y7f . Wj
PLAN CHECK FEES $
SETBACKS LEFT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO