HomeMy WebLinkAboutPV2022-018 - Permit ApplicationPrint Form g Worksheet for Combo Building & Solar PermitApplication
�j Comm'I 17 Residential ity of Newport LAN CHK F ES UE AT BuildingBeach - Division
ME OF SUBr yon-01
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(Building (IGrading f7Draihage ❑Elec F,Mech FPlum cuydcutn Cu ydFiun
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Project Address (Not mailing address) ❑ Flood n Fire Fi Liq F7 Landslide �N/A Floor Suite No
Description of Work
Use F7ConstType 7
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5M)6 Noe
# Stories # Units (if Res) F7
Va$
Malten
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New/AddSFF__ Remodel SF Garage/New/Add , I
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OWNER'S NAME Last First
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Owner's Address Owner's E-mail Address
City J State Zip[7,11, Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City - - State F Zip Telephone
ARCHITECT/DESIGNER'S NAME Last FirstI
Lic. No. 1
Architect(Designer's Address Architect/Designer's E-mail Address
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City State 7_7 Zip t Telephoned
ENGINEER'S NAME Last F_ First Lic. No.�
Engineer's Address Engineer's kimal, Address
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City I State Zip Telephone
CONTRACTOR'S NAME/COMPANY l V Lic. No. Class!
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Contractor's Address Contractor's E-mail Address
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city State - Zip Telephoned
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SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT PERMIT NO. i tz-vile),
SETBACKS RIGHT PLAN CHECK NO. 0��4.Y
DEVELOPMENT NO PLAN CHECK FEES $