HomeMy WebLinkAboutX2022-1306 - Permit Application1_ Print Form Worksheet for Combo Building & Solar Permit Application (�xk-!%w,,�,
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F Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHFCK FFF.R ni IF AT TIN= n❑ ci lohm r
F-Building F_Grading F-Drainage F_Elec Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing ad/d�.r�ess)1F Flood r Fire r Liq j- Landslide FN/A Floor Suite No
Description of Work
Use ConstType�
# StoriesF # Units (if Res)_
Valuation $
Material/Labor
New/Add SF f Remodel SF Garage/New/Add �—
OWNER'SNAME Last First
Owner's Address
Owner's E-mail Address
city State �- ZIP �— TelephoneF—
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— ZIP Telephone—
.__.-_.
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
-- - -
City State � Zlp �— Telephone[ —
ENGINEER'S NAME Last First F Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State �® Zip �— Telephoner
CONTRACTOR'S NAME/COMPANY Lic
1 Class
Contractor's Address Contractor's E-mail Ad '/J`PL
' P'
City �- State F— Zip F TelephoneF�
SETBACKS REAR SETBACKS FRONT PERMIT NO. O
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N
USE ZONE DEVELOPMENT NO PLAN CHECK F