HomeMy WebLinkAboutX2022-1708 - Permit ApplicationPrint Form Worksbeot for Combo Building & Solar Permit Application
- --
City of Newport Beach -Building Division JC2�ZZ
Comm'I F Residential U
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �<FonN
F—Building F_ Grading F-Drainage F_ Elec F_ Mech F Plum Cu Yd Cut Cu Yd Fill
project Address (Not mailing address) C Flood ( Fire F_ Liq F_ Landslide [N/A Floor Suite No
o t4te, hoer 4�w.A.n JnJAP, 1 771 .,
on of Work
Use I— Const
# Storiesl_/__#�_units (if
Valuation '
New/Add SF[— Remodel SF�— Garage/New/Add �— Material/L borl . . ... .. ......... .
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
[_ ____ - - -- - -------------_----
----- -. - ------- _ . .
City State Zip — Telephone
I . APPLICANT'S NAME Last First
............ ......;-- ...... __.. _ ..__
Applicant's Address Applicant's E-mail Address
....... . _ _
City State �— Zip �— Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
city State Zip Telephone
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT
PLAN CHECK NA QI
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $