HomeMy WebLinkAboutPV2022-0299 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application EW Pp
F Comm'I r Residential City of Newport Beach - Building Division t� �
NOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL R>
FBuilding j— Grading (—Drainage IF r Mech r plum cuvdCut
Cu Yd Fill
Project Address (Not mailing address) Flood ( Fire r Liq r Landslide (—N/A Floor Suite No
��V 4 1 6 W
New/AddSFF— Remodel SF�—
OWNER'S NAME Last
Owner's Address
�It V i
City �1 State F—
APPLICANT'S NAME Last
Applicant's Address
City State �—
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
City
ENGINEER'S NAME
Engineer's Address
City
Use F ConstTypeF—
# StoriesF— # Units (if Res)[—
Valuation $
Garage/New/Add —
Material/Labor viol
_
First
Owner's E-mail Address
Zip [— Telephone
First ) (OTf
Applicant's E-mail Address
SCn ��ltS�V�SranL�. (¢l�
Zip �— Telephone (�",�� yo
First) Lic, No. F —
Architect/Designer's E-mail Address
State F— Zip Telephone
Last I First F--
Lic.
Engineers E-mail Address
I
State F— Zip F— TelephoneF�
CONTRACTOR'S NAME/COMPANY `F'�----- Class ���
LicNo.l IU Sll[�I
Contractor's Address Contractor's E-mail Address
City T Y rI, /�(Ytic State — Zip j //FIv j Telephone wl X -0t,
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.-�Z
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $