HomeMy WebLinkAboutXC2022-1902 - Permit Applicationprint Form Worksheet for Combo Building & Solar Permit Application
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— City of Newport Beach - Building Division }
F Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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JBuilding ❑Grading [Drainage [\Elec XMech Plum cuvdCut�� _ -
Flood Fire Liq ❑ Landslide CiN/A Floor Suite No
Project Address (Not mailing address) ❑ C �' I ,
Description of Work
New/Add SF�—I Remodel SF
OWNER'S NAME Last
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# StorlesM # Units (if Re5)e11
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Valuation 5
Garage/New/AddMaterial/Lahor 1•'%U�
Owners Address Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
City DLit - State
C.71-
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address '
City ''C �j !"E• �l(J State (,•F`
First
Zip }
E-mail Address
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LicNo.Architect/DesidressC AA
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ENGINEER'S NAME Last
—� First J Lic.
Engineer's Address Engineer's E-mail Address
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Telephone[—j
City State — Zip
P-
i Lic.No. � l Class
CONTRACTOR'S NAME/COMPANY `) �_ _ b c� �W u✓�/_ __
-i- Contractors E-mail Address
Contractor's Address ,
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City IQi - — ---- State ZIP -� �I�J
SETBACKS REAR SETBACKS FRONT
-ETBACKS LEFT SETBACKS RIGHT
PERMIT NO. fuzz Z" 1 40L
PLAN CHECK NO ft?AT t- tOOZ
PLAN CHECK FEES $
ZONE
DEVELOPMENT NO