HomeMy WebLinkAboutX2022-0733 - Permit ApplicationCity of Newport
___-_I NOTE: PLAN CHECK FEES g ATTIMEOFiSUBMITTAL pp uo
Print Form Worksheet for Combo Building & Solar Permit Application of -P
Comm'I r Residential
F_Building rGrading r—Drainage rElec rMech
v
Plum CuYdCut s CuYdFill
Project Address (Not mailing address) F Flood F_ Fire r Liq F_ Landslide F_N/A Floor Suite No
1895, 5ker,w TOYL
tack
I S30
F3 —
Description of Work
Use s ConstType s
It Stories # Units (if Res)_
Valuation $ a
Material/Labor
New/AddSF1 Remodel SFF --- Garage/New/AddF—
OWNER'S NAME Last F
First
Owner's Address
Owner's E-mail Address
City
State F
Zip F_ Telephoned
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City I
State
Zip F— Telephones--
ARCHITECT/DESIGNER'S NAME
Last First 7—
Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
State �—
Zip Telephones--
ENGINEER'S NAME Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State
Zip F_ Telephone F_
CONTRACTOR'S NAME/COMPANY
Lic. No. �— Class
Contractor's Address
Contractor's E-mail Address
City
State F_—
Zip F_ Telephones
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $