HomeMy WebLinkAboutS2022-0175 - Permit ApplicationPrint Form Worksheet for Combo Building Oww
ng &Solar Permit Applicationr Comml j) Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) 1- Flood F- Fire F_ Liq Landslide I -N/A Floor Suite No
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Description of Work
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OWNER'S NAME Last
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Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last First
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Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last -1- Pto0... First ?e")'e1�' Lic. No. !.I-7 !_�J Zi?
Architect/Designer's Address Architect/Designees E-mail Address
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ENGINEER'S NAME Last First �ILic. No. �-5 g003
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY l Lic. No. }S � �O 5 Class��
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Contractor's Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. - V 1 l 5
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. (wZ , ZC) L1
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $