HomeMy WebLinkAboutPV2022-0235 - Permit ApplicationPl;nt Form ►�lorks9�ee# for Combo Building &Solar Permit Application CIIIU20
Cit of New ort Beachg- Buildin Division
Comm'I ( Residential. NOTE: PLAN CHECK FEES DUE AT TIME nF .qI iRnniTToi
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j Plum CuYdCut CuYdFill
Project Address (Not mailing address) F- Flood
j- Fire Liq r Landslide FN/A Floor Suite No
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Description of Work
Use x� Const Type
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# Stories # Units (if Res)F_
Valuation $
Material/Labor
New/Add SFF— Remodel SFF— Garage/New/Add F
OWNER'S NAME -
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First _ `-1 L'lU ✓'�1C4
Owner's Address Owner's E-mail Address
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city
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APPLICANT'S NAME Last C, Y L� 1 Cj I t l
First ) I t
Applicant's Address J
Applicant's E-mail Address
City,.St�.te
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zip
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ARCHITECT/DESIGNER'S NAME Last } AF t
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Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
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City C
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`; Telephone C l C' ��'
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ENGINEER'S NAME Last
First ®
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Engineer's Address
Engineer's E-mail Address
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city-
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(•, t u' Telephon ,iL�
CONTRACTOR'S NAME/COMPANY t�
Lic No. lass�j
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Contractor's Address L
Contractor's E-mail Address
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TelephoneLjL�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $