HomeMy WebLinkAboutX2022-0752 - Permit ApplicationL Print Form
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Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIMIF OF.Ri IRRAITTAI
F—Building f7 Grading F—Drainage F_ Elec F_ Mech F== plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F Fire F_ Liq F_ Landslide F_N/A Floor Suite No
F
Description of Work
Use F—Const Type 77
(J
Stories[ # Units (if Res)[7
New/Add SFF— Remodel SF Garage/New/Add
Valuation $
Material/Labor
OWNER'S NAME Last Firstl
Owner's Address Owner's E-mail Address
0 IF IKL_
City T
State Zip �� Telephone 3�c
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
CityF— State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last'Tl First Lic. N04��,� �T-5
Architect/Designer's Address Architect/Designer's E-mail Address
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CneFj"-
City State e;lIZ— Zip r� T-e Zhc
ENGINEER'S NAME Last FirstF;7�77_— Lic. No.
Engineer's Address Engineer's E-mail Address
City State
F—F_ Zip TelephoneF_
CONTRACTOR'SNAME/COMPANY Lic. No. ClassF_
Contractor's Address Contractor's E-mail Address
City + State Zip F—Telephone[®
SETBACKS REAR SETBACKS FRONT PERMIT NO, Nofn I
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N 0.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $