HomeMy WebLinkAboutXR2023-0456 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar P
F Comm'I j Residential Cit Y of Newport Bermit Application , Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address Plum Cu Yd Cuts
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Description of Work ----
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Garage/New/Add � Valuation'
OWNER'S NAME Material/Labor Fv
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Last
Owner's Address --- First
fq r n t, i Owner's E-mail Address
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APPLICANT'S NAME Zip i z, 4.- Z Telephone —
Last
Applicant's Address First
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City
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ARCHITECT/DESIGNER'S NAME Zip ���"� _ Telephone 7r y 7YZ �r
Last
Architect/Designer's Address First--
Lic. No.
Architect/Designer's E-mail Address
City -
- State Zip
Telephone��
ENGINEER'S NAME
Last Y7Ait si ,q r>
First 4rl �A/Li
Engineer's Address r3 _ Lic. No. Z _�;ri,F ,/ a,
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Zip 9271 1 Telephone
CONTRACTOR'S NAME/COMPANY
Contractor's Address iN c Lic No. Class-
2 G c o S �� N 5j Contractor's E-mail Address
City SyNtA iaa vA� =
State I c'' r-7
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SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT PERMIT NO. n
— 7 (�
USE ZONE PLAN CHECK N0.
DEVELOPMENT NO
PLAN CHECK FEES $