HomeMy WebLinkAboutPV2022-127 - Permit ApplicationR-9
pzfti Worksheet for Combo Building 8r Solar Permit Application
Comm residentialCity of Newport NOTE: PLAN HECK FES UE Buildingeach - Division
T TIME OF SUBMITTAL 2ti` ���
/Building F_, r;Drainage rElec j-Mech rPlum cuvdcutF —j cuvdFill F_'
Project Address
of Work
F7 Flood
r Fire [7 Liq i! Landslide
,N/A Floor
Suite No
New/AddSFF— Remodel SFF— Garage/New/Add
Use ( Const Type 0
# StoriesF # Units (if Res)F_
Valuation $ F
j00Material/Labo
APPLICANT'S NAME Last
Applicant's Address
City CEts State
First) V��
Applicant's E-mail Address
govt,
Zip ai2(2 i Telephone qpg ygq- 3S 3
ARCHITECT/DESIGNER'S NAME Last FirstF Lic. No. F
Architect/Designer's Address
City State
Architect/Designees E-mail Address
Zip Telephonel�
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ENGINEER'S NAME Last 1 A 9 First �� Lic. No. CCrylG 3
Engineer's Address
City I State F p; -
Engineer's E-mail Address
Zip �Z-u't8g Telephone
CONTRACTOR'S NAME/COMPANY 4t
66 / r Lic. No. ,/62424 Q ClassV 199
F.W. Q
Contractor's Address
City State F5
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
Zip cI+ ik z_j Telephone `09 - W9- 39'3,3
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $