HomeMy WebLinkAboutXC2022-2007 - Permit ApplicationL` Print Form
�^J Worksheet for Combo Building & Solar Permit Application o��ewPO
City of Newport Beach - Building Division NOVj— Comm] Residential K �� i"� z
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT
F7Building r Grading F—Drainage F_ Elec F_ Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire F_ Liq f— Landslide F_N/A Floor Suite No
F-
Descriotion of Work
New/Add SF Remodel SF Garage/New/Add
NAME Last
licant's Address
ity State F_
/DESIGNER'S NAME Last
Architect/Designer's Address
City State �—
Use Const Type F
# Stories7 # Units (if Res)F_
Valuati 6n$
Materior
First Lic. No.
Architect/Designer's E-mail Address
Zip F— Telephone
ENGINEER'S NAME
Last First F Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
-.
CONTRACTOR'S NAME/COMPANY /7 Lic. No. �� Class
" Gr'/S
Contractor's Address Contractor's E-mail Address
City CG, r-, r> State Zip / Telephone �) (/�+ Z77 6 717
V n 1
SETBACKS REAR SETBACKS FRONT Z YUITN0 XC2o_zz' V,
SETBACKS LEFT SETBACKS RIGHT v PLAN CHECK NjCZ�CJ''JO
USE ZONE _ DEVELOPMENT NO _ PLAN CHECK FEES $