HomeMy WebLinkAboutXR2022-3242 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Print n City of NewportE
each - Building Division Vq
Kcomm,l residential NOTE: PLAN CHECK FSDUE AT TIME OF SUBMX I � tzl-�zq z I
ITTA
F/13uilding F_ Grading f—Drainage F_ Elec Mech F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood f— Fire 17 Liq F_ Landslide
F_N/A Floor
Suite No
_A&IN .. . .......
Description of Work 7-10P ?e-q e
/
New/Add SF
,/ e-, -,, A
U sq/�yb�, Co n st Type
# StoriesF-,?�7 # Units (if Resf
zzdAi Valuation $
e�7m e7d
SFGarage/New/AddF— M
aterial/Labor
APPLICANT'S NAME Lastl First 1 \"),4
Applicant's Address Applicant's E-mail Address
...........
... ..........
City State Oi Zip Telephone X) .14-
ARCHITECT/DESIGNER'S NAME Last First [ 12-Alt,10
/ . �A;,V/ Lic. N
Architect/Designer's Address Architect/Designer's E-mail Address
vi
...... .. .............. .... . ....
City.F.—I I . ..... Zip Telephone
ENGINEER'S NAME Last First F Lic. No.i.
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. FT—_qT-T-'_5Class
F7_
Contractor's Address Contractor's E-mail Address
city F—State Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.. Moo&?- 3zqz.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $