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HomeMy WebLinkAboutX2022-0604 - Permit Applicationl Print FdiT I Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division , -,� "- �u jA Comm'I (` Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL` `""" F_ Building F Grading [—Drainage j— Elec j— Mech F— Plum Cu Yd Cut Cu Yd Fill F Project Address (Not mailing address) IW Flood [_ Fire j- Liq r" Landslide nl a^rimfinn of Wnrk New/Add SF Remodel SFF Garage/New/Add OWNER'S NAME Last First rN/A Floor 5_s� Suite No Use Con stType F # StoriesF # Units (if Res)_ Valuation $ Material/Labor Owner's Address Owner's E-mail Address City State F Zip—� Telephone APPLICANT'S NAME Last M First Applicant's Address Applicant's E-mail Address City C-00pr,04 State CO • Zip Telephone Z3 , ;aS(e' I % S 1S ARCHITECT/DESIGNER'S NAME Last I First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address 7 F_ City � � State Zip [ ' Telephoned ENGINEER'S NAME Last First Lic. No.1 Engineer's Address Engineer's E-mail Address City State �� Zip F TelephoneF— CONTRACTOR'S NAME/COMPANY /' lily . /� ' /�_ I� Lic. No. v/s-©(e Class U Flo A ' d 6 ldLhriJ Contractor's Contractor's E-mail Address 4477 R0Ft• City GFoeuill—&State �Z Zip ���(p Telephone (oZ3-9/87-Q23c1 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. SSE ZONE DEVELOPMENT NO PLAN CHECK FEES $