HomeMy WebLinkAboutX2022-0871 - Permit ApplicationPrint Foirm Worksheet for Combo Building & Solar Permit Application 1_WP0
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F_ Comm'I F_ Residential City of Newport Beach - Building Division _Q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U `6
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I'luilding [_ Grading f—Drainage f,_,"Elec �ech Plum Cu Yd Cut F_ Cu Yd Fill [_
Project Address (Not mailing address) F_ Flood r Fire Liq Landslide F_N/A Floor Suite No
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P_ LLB D irC _ C eq�-C
Description of Work
Use Const Type
# Stories 7 # Units (if Res)—
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Valuation $
Material/Labor
New/Add SF[ Remodel SF 15..EGarage/New/Add F
OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
City FrEv State
Zip Telephone
APPLICANT'S NAME Last First F
Applicant's Address Applicant's E-mail Address
AA \V t 1A
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City State Zip L)SO Telephone
ARCHITECT/DESIGNER'S NAME Last First n P_ n -L)n Lic. No. FT Z, 2-
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Architect/Designer's Address Architect/Designer's E-mail Address
7�DL) .50,5. GJ_LLL.
Zip q) Telephone
City State -2) 5
ENGINEER'S NAME Last dN c, i, I\ e.,e. r, First[ Lic. No.
F
Engineer's Address Engineer's E-mail Address
Y V
City State 7CA Zip I q1 TelephoneFl 4q - Z(,-7 - ,nqs
CONTRACTOR'S NAME/COMPANY t�-vv, c/ Lic. No. Class
V6
Contractor's Address Contractor's E-mail Address
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City Trv.,v\(L State FC Zip Telephone Wl--q T- 6 � _-z - og
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $