HomeMy WebLinkAboutXR2022-2676 - Permit ApplicationPrintForm Worksheet for Combo Building & Solar Permit Application o�
Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF RI IRnniTTni
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Description of Work
Use F ConstType F
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# Stories # Units (if Res)
New/Add SF_Remodel SF /7� v ` Garage/New/Add �—
Valuation $
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OWNER'S NAME Last � _ First
Owner's Address Owner's E-mail Address
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APPLICANT'S AME Last 1 i First
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Applicant's Address Applicant's E-mail Address
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ARCHITEC DESIGNER'S NAME Last ,
J y- � First ` �/r i%1"V) Lic No.
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Architect/Designer's Address Architect/Designer's E-mail
City 11 f /rj State Zip (, Telephone
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ENGINEER'S NAME Last d?f ; '
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Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY Lic. No. F — ClassF_
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Contractor's Address ll� / Contractor's E-mail Addres
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City �-- State — Zip r--- vTelephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO / b
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $