HomeMy WebLinkAboutX2022-1783 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oM�ra
r C. mml F_ Residential City of Newport Beach - Building Division f i
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building F_GradingF—Drainage F_Elec F_Mech (—Plum CuYdCut CuYdHI _r
Project Address (Not mailing address) F_ Flood F_ Fire j— Liq F_ Landslide [N/A Floor Suite No
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Description of Work
Use F_Const Type \/5
Stories # Units (if Res)[_
Valuation $
Mate ial/Labor
New/Add SFF Remodel SF 2 S Z Garage/New/Add
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
Cityo �� ), State Zip J Telephone
c
APPLICANT'SNAME Last First
Applicant's Address Applicant's E-mail Address
City State �— Zip F Telephonel—
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip Telephoner
ENGINEER'S NAME Last F— First Lic No. F—
Engineer's Address Engineer's E-mail Address
City �® State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F/OTt 697Class
Contractor's Address V Contractor's E-mail Address
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5 % 7 % 'z lliw tely T7 t Cd �-�
City State 1A Zip Telephone C7
SETBACKS REAR SETBACKS FRONT PERMIT NO. /\ZOV —1783
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. FigV Z2 — F'�W
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $