HomeMy WebLinkAboutX2022-1026 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building -Grading
j-Drainage F_Elec FMech F_ Plum Cu Yd Cut Cu Yd Fill
ProjectAddress (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide [_N/A Floor Suite No
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D scription of Work
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Use Const Type
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WIC
#Stories # Units (if Res)F
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Valuation $
New/Add SFF
Remodel SF F Garage/New/Add F
Material/Labor
1
OWNER'S NAME Last First M�G
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Owner's Address
Owner's E-mail Address
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City I D�
State Zip 1pl —ij Telephone
APPLICANT'S NAME
Last First ti 161AA Vl..,/
Applicant's Address
Applicant's E-mail Address
City
V State F_ Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME LastmliwvFirst Lic. No.
Architect/Designe 's Address
Architect/Designer's E-mail Address
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tate ✓✓✓✓���, ���` Zip I Telephoner , , p ,1111
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ENGINEER'S NAME
Last First� Lic.
Engineer's Address
Engineer's E-mail Address
City �
State F_ Zip TelephoneF_
CONTRACTOR'S NAME/COMPANY Lic. No. F ClassF_
Contractor's Address
Contractor's E-mail Address
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City f
State F_ Zip F Telephoner
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. x W 2 Z -I DZ6
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. OZ7S'ZOZZ
USE ZONE
DEVELOPMENT NO 1220 7 7 —0OQ_ PLAN CHECK FEES $