HomeMy WebLinkAboutPV2022-060 - Permit ApplicationPrint Form W � eet for Combo Building & Solar Pe WL
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F, Comm" r; Residential City of Newport Beach - Building Divisio
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB I °+<�roa""
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Project Address Not mailing address N
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Description of Work
Use F Const Type F
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# Stories7 #Units (if Res)
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Valuation $ O
Material/Labor
New/Add SF Remodel SF�I Garage/New/Add i
OWNER'S NAME Last MC6011OG� First
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Owner's Address Owner's E-mail Address
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City A k � e-L� State t t
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City IJyI� I State Zi(� Telephone GU3o S6pl
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ARCHITEC SIGNER'S NAME LastFirst
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Architect/Desi s s Architect/Designees E-mail Address
City State Zip I Telephone�—
ENGINEER'S NAME Last V U�nr� FirstLic. No. [-7W A
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Engineer's Address Engineer's E-mail Address
City y:KW� State r Zip r 92z l Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. qac )15 Class _
Contractor's Address Contractor's E-mail Address
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city iState Zip�Telephone6 Z ZiV �00
SETBACKS REAR SETBACKS FRONT PERMIT NO. s�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $