HomeMy WebLinkAboutX2022-1143 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (OVCity of Newport Beach - Building Division
Comm'I F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F;Building r Grading
v
F-Drainage rElec F-Mech F- Plum CuYdCut CuYdFill F
Project Address (Not mailing address) 1- Flood r Fire r Liq j-- Landslide I -N/A Floor Suite No
Description of Work
Use ConstType
3 .5, Vl�; YI 4l c_1/kIr
I �i,, �',[_�_ /I 1 i i Ci �l i��l�it Sl
# StoriesF # Units (if Res)F_
New/AddSF�—
Remodel SF� Garage/New/Add—
Valuation $
Material/Labor
OWNER'S NAME
Last First
H
Owners Address
Owner's E-mail Address
City State :� Zip 1 TelephoneF_
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State F_ Zip r— TelephoneF_
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F Zip F Telephone�—
ENGINEER'S NAME
Last First Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State Zip F_ TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic. No. �- ClassF
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip F_ Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. �ZC) 22-,j` q 5
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N0. 6 0S 5 -ZOZ 1�/�ZZ U�t
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ 1 GZ ,q q