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PV2022-040 - Permit Application
i Print Form I l,Iilorksheet for Combo Building & Solar Permit Application r Comm'I )� Residential City of Newport Beach - Building Division Q zz,(/ Ito NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building Grading Drainage Elec Mech Plum Cu Yd Cutr Cu Yd Fill Project Address (Not mailing address) F_ Flood r Fire j- Liq j- Landslide F_N/A i5 i 7 �l�a Description of Work Floor Suite No I— F_ Use I— Const Type # Stories[ # Units (if Res)F - Valuation $ New/Add SF Remodel SF Garage/New/Add �� Material/Labor D OWNER'S NAME Last N First Owner's Address Owner's E-mail Address .......... -.......... . --- _ - City I�/✓��„f-� State Zi �} Telephone p APPLICANT'S NAME Last �{ I First Applicant's Address Applicant's E-mail Address iry I city /C State �'A Zip �� Telephone ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip F— Telephone CONTRACTOR'S NAME/COMPANY S C j Lic. No. r{ Class A�$ Contractor's Address Contractor's E-mail Address / f� City --�_ State (�� Zip o1©p Telephone .. ........ _ SETBACKS REAR SETBACKS FRONT PERMIT NO. Pb 20ZZ— V 7,1 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. P(:&22 L USE ZONE DEVELOPMENT NO PLAN CHECK FEES $