HomeMy WebLinkAboutXR2022-2901 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I j- Residential City of Newport Beach - Building Division-1 yr _ \
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) I- Flood r Fire r- Liq r Landslide [_N/A Floor Suite
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Description of Work
Use F—ConstType
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# Stories[ # Units (if Res)F
Valuation $
Material/Labor
New/Add SF /1J/ A Remodel SF Garage/New/Add F—
OWNER'S NAME
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First
Owner's Address
Owners E-mail Address
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State 1(94
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APPLICANT'S NAME
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Applicant's Address
Applicant's E-mail Address ���✓�/�p�%i. /r�> L4a
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State ��
Zip / Telephone f)r G ,_C566,0
ARCHITECT/DESIGNER'S NAME
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Last �/.-First I / , j� Lic No.
Architect/Designers Address
Architect/Designer's E-mail Address
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City
State �—
Zip F— Telephone 91/ 9r -7r A7 / 3
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ENGINEER'S NAME
Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY �y�/7�
C���J L i c. No. L ClassF
Contractors Address
Contractor'sE-mail Address
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City qn
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO.ZpZZ-Z�jp
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. PG 2022 - Z-7Sn
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $