HomeMy WebLinkAboutPV2022-0402 - Permit ApplicationPrint Form WorksheLit for Combo BuBding & Solar P&m'it Application
City of Newport Beach - Building Division L)
F_ Comm'l F_ Residential b 'U I
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NOTE: 'PLAN CHECK FEES DUE AT TIME OF SUBMIfIAILZO (5s.'o",
ding F_ Grading f—_Drainage VEIec F Mech F— Plum Cu Yd CutF Cu Yd Fill
Project Address (Not mWflnq address) [_ Flood F_ Fire r— Liq r Landslide F_N/A Floor Suite No
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Description of Work
Use F—Const Type F-
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# Stories # Units (if Res)
r')A 1) Jk4 0 N VM-6t�-r ,
Valuation $
Material/Labor
New/Add SF Remodel SF Garage/New/Add F
OWNER'S NAME Last First D
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Owner's Address
Owner's E-mail Address
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Slate
City A P ZiPF'� Telephone
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City tate _�2, Telephone
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ARCHITECT/DESIGNER'S NAME Last [_ First Lic. No.
Architect/Designer's Address Arch itect/Designer's E-mail Address
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City State F Zip Telephone
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
...... . .. ..... .. . ......
City F_ State zip Telephone F
CONTRACTOR'S NAME/COMPANY �� t-V1Lp60_ �e> INC Lic. No. Class
Contractor's Address Contractor's E-mail Address
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City I (ADS A LA vt State JC A Ziplej-"(D7�2_(D Telephone I
SETBACKS REAR SETBACKS FRONT AW Al�kMIT NA
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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