HomeMy WebLinkAboutX2022-0625 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
Comm'I ��Reslclential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) r Flood
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Description of Work
Use t ConstType
Stories # Units (if Res)F_)
Valuation$
Material/Labor
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IWNER'S NAME Last
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Pwner's Address U
Owner's E-mail Address
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LICANT'SNAME Last VU `dC`il�3
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Iicant's Address
Applicant's E-mail Address
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ARCHITECT/DE IGNER'S NAME Last �% -, Y;`J
First (� I I i Lic No.
ArchilecUDesigner's Address
ArchltecUDesigner's E-mail Address
Ciry State
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Zip (r � Telephone i 1 l) & 74
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ENGINEER'S NALast IU\2Y1 Sj_
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First - �hLic.No.
Engineer's Address
E gineer'sE-mail Address
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CONTRACTOR'S NAME/COMPANY
Lic, No. {Class
Contractor's Address
Contractor's E-mail Address
City State F— Zip F Telephoned
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.YU V2. ' OfoZ
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Q �®
USE ZONE DEVELOPMENT N
PLAN CHECK FEES $
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