HomeMy WebLinkAboutX2022-1705 - Permit ApplicationLPrint Form, Worksheet for Combo Building & Solar Permit Application
[ Comm'] [ 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) G Flood ❑ Fire C Liq [I Landslide [N/A Floor Suite No
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New/Add SF�__ Remodel SFC Garage/New/Add �'I
OWNER'S NAME Last
Owner's Address
City I State
APPLICANT'S NAME Last
Applicant's Address
city State
ARCHITECT/DESIGNER'S NAME Last F
ArchitectlDesignees Address
City �— — State
First
Owner's E-mail Address
First
Use ' ConstT a (�
YP F I
# Stories # Units (if Res)C
Valuation 5
Material/Labor 1,12 C Z
Applicant's E-mail Address
Zip F Telephoned
—
First Lic. No.
Architect/Designer's E-mail Address
Zip F-7-1 Telephone —
ENGINEER'S NAME Last First Lic. No.��,
Engineers Address
City State C
Engineer's E-mail Address
Zip TelephoneF--------
CONTRACTOR'S NAME/COMPANY • Lic. No. �— ClassC%
Contractor's Address
City -- ---------- State �—
SETBACKSREAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
Zip �— Telephone j
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PERMIT NO. x2o2? - 1705
PLAN CHECK NO. 7-1 gh�• 702 0
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $