HomeMy WebLinkAboutX2022-0452 - Permit ApplicationPrint Form_orksheet for CombOPuilding & Solar Permit Application
r Comm'I.,Residential City of Newport Beach - B 'I
w ding Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL.119ta° aoa
Building r Grading j—Drainage e
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Cu Yd cutl AJA Cu Yd Fill JL�Q Project Address (Not mailing address) r Flood j'- Fire j'- Liq �"" Landslide (-N/A
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New/Add SFr
OWNER'S NAME
Owner's Address
RemodelSF1 9-
Last
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APPLICANT'S NAME
Applicant's Address
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City
# StoriesFV # Units (if Resi ,
Garage/New/Add � I Valuation s
Material/Labor
First
Owner's E-mail Address
State
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Last l G
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ARCHITECT/DESIGNER'S NAME
A-1:.
Applicant's E-mail Address
State ��
Zip Telephone
11«wuesigners Address
City State
ENGINEER'S NAME
Last I� •� l n,r ,�.
Engineer's Address
City TY/Iqr � State I ��
CONTRACTOR'S NAME/COMPANY
First_--
Lic. No. �
Architect/Designer's E-mail Address
ZIP Telephone `
First I ,,,>-- Lic. No.
Engineers E-mail Address
Zip Telephone 7 / G y�q
Lic. No.✓ Class��
actors Address / S/✓
t�i.Ga�% 71 Contractor's E-mail Address
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f W.NVt `�tCf girl ZIp'1�.j� Telephone �45�7�
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO,
i USE ZONE
DEVELOPMENT NO
PLAN CHECK NO.
PLAN CHECK FEES R
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