HomeMy WebLinkAboutPV2022-012 - Permit ApplicationPrint Form Worksheet for Co o Building $Solar Permit Application
City of Newport Beach - Building Division I 4
Comm'] Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL C Y LOU 0
rBuilding r Grading
[—Drainage r Elec r Mech I— Plum CuydCut cuYdFill F
Project Address (Not mailing address) I— Flood F_ Fire j— Liq I— Landslide FN/A Floor Suite No
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Description of Work
Use F_ Const Type
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#Stories #Units (if Res)I
A
valuation $
New/Add SFF
Remodel SFF Garage/New/Add F—
Material/Labor
OWNER'S NAME
Last '< First Elx�z_.
Owner's Address
/y
Owner's E-mail Address
City
State Zip 9_ 4 Telephone O
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip F_ Telephoned
ENGINEER'S NAME
Last First [_ Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY [�(( �Qr+� �PyfrlC/ �C Lic. No. 77SSq g Class C 10
Contractor's Address
Contractor's E-mail Address
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City V ®.
State I i Zip q2BG7 Telephon Sag �SOy
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. l-10 1 - logo
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $