HomeMy WebLinkAboutX2021-1987 - Permit Application (2)Print Forrrr` ,` Worksheet for Combo Building &Solari
Permi Application
j�
(- Comm'I ity of Newport
Residential NOTE: PLAN CHECK EES UE AT TIME OF SUBMI
Building [ Grading
F -Drainage Ji lec rMech 2Plum cu rd cutl Cu Yd Fill
Project Address (Not
mailing address) [ Flood F_ Fire r Liq F- Landslide CN/A Floor Suite No
Description of Work
Use F—Const Type F
u
\
# Stories nl ,.!7 ReF)
Valuation $ + F
Material Labor 1 ✓ t��
New/Add SFr 4Ej
Remodel
SSFFF Garage/New/Addy
OWNER'S NAME Last First _ AAA
Owner's Address
Owner's E-mail Address
City
? State �Y Zip qr Telephone'a(g j L
APPLICANT'S NAME
Last lJ� First CFPSF1
Applicant's Address
Applicant's E-mail Address
-� nc)o
city ��
State. Zip 1 /Zllb_ TelephoneF
ARCHITECT/DESIGNER'S NAME Last First
�-- _ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip r Telephone'
ENGINEER'S NAME
Last _ First F_ Lic. No.r\I
JJ
Engineer's Address
_
Engineer's E-mail Address
City
State—' Zip r— Telephone
CONTRACTOR'S NAME/COMPANY Lic N0.•! Class
Coontractor's Address
Contractor's E-mail Address
City -. ` \
- State U Zip F Telephone r K 65{ oc,;k)
SETBACKS REAR
SETBACKS FRONT PERMIT NO. T O IW
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. `1 ;1
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
14