HomeMy WebLinkAboutREV22-0600 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm'I Fi Residential City of Newport Beach -Building Division ?,8V2�0(4 o O
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding ' Grading [f6rainager Elec ''C Mech n Plum "'CuvdcutCuvdFill
Project Address (Not mailing address) ❑ Flood I Fire j`; Liq [ Landslide nN/A Floor Suite No
Description of Work
Use Const T Ype
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# Storiesn # Units (if Res)�I
Valuationl40�%
Material/Laa b
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New/Add SF J Remodel SF� J Garage/New/Add
OWNER'S NAME Last `/� -- - .- First -���
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Owner's Add`reesss Owner's E-mail Address
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CityI A, State �� - Zip a_ Telephone 7 p
APPLICANT'S NAME Last-,-- First/YIG� _1 r�--- --_— _I
Applicant's Address Applicant's E-mail�Address
City !�T � ,� _ems AL State � Zip I p -,I Telephone )
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ARCHITECT/DESIGNER'S NAME Last First Lic. No. F 77
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Architect/Designer's Address Architect/Designer's E-mail Address
City -� State - � Zip I I Telephoned
ENGINEER'S NAME Last First i Lic. No.�
Engineer's Address Engineer's E-mail Address
City /��!V J State Zip - Telephone Z77
CONTRACTORS NAME/COMPANYLic. No. Class 777-1-7
Contractor's Address Contractor's E-mail Address
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City n/1 �D State Zipl Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. 1`6VZli& OW 00
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 17,#V,
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USE ZONE DEVELOPMENT NO PLAN CHECK FEES $