HomeMy WebLinkAboutX2022-0591 - Permit Applicationv-W zZ- a3s,3
Print Form Worksheet for Combo Building & Solar Permit Application o4 `� °°e
F comm" `(Residential City of Newport Beach - Building Division
`` NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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OWNER'S NAME
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Owner's E-mail Address
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APPLICANT'S NAME
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Applicant's Address
Applicant's E-mail Address
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.ARCHITECT/DESIGNER'S NAME Last /rho 6-7 1�. � First G
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Architect/Designer's Address
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ArchitecVDesigner's E-mail Address
City
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Zip F— Telephoned
ENGINEER'S NAME
Last
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First (� Lic.No.F
En}gineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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'Contractor's
Contractor's Address
E-mail Address _
City
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Zip F_ Telephone��
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. VV
- SETBACKS LEFT
- SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $