HomeMy WebLinkAboutXR2022-3078 - Permit ApplicationF rintForm Worksheen for Combo Saddling & Solar Permit Application
r Comm' rsider�tial City of Newport Beach - Building Division
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Project Address (Not maohmg address) [ Flood f Fire r Liq r Landslide F_N/A Floor Suite No
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Description of Work
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Garage/New/Add �—
Valuation 5
Material/Labor
OWNER'S NAME Last L .
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Owner's Address
�� G1Owners E-mail Address
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APPLICANT'S NAME Last l�'t�{�i First ) t I61
Applicant's Address W'�? �r,�{-(�� h Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last f First �— Lic No. F—
ArchitecUDesigner's Address Architect/Designer's E-mail Address
City State F ZIP Telephoner
ENGINEER'S NAME Last �� First F—Lic. No.
Engineer's Address Engineers E-mail Address
City State �� ZiP 1 Telephone
CONTRACTOR'S NAME/COMPANY / II, r..,
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Contractor's Address Contractor's E-mail Address 5
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N
USE
ZONE DEV�LfEUNO PLAN CHECK FEES $