HomeMy WebLinkAboutX2022-1285 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application °Rra
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U
F_ Building r Grading
[—Drainage F Elec r Mech r Plum cuYdCut CuYdFill
Project Address (Not mailing address) F_ Flood F Fire F- Liq F_ Landslide F_N/A Floor Suite No
- 2,94 - kk)P-M TL F_
Description of Work
Use ConstTypeF__
# StoriesF_ # Units (if ResF_
New/Add SFF__
Remodel SFF — Garage/New/Add i
Valuation $
Material/Labor
OWNER'S NAME
Last 1 First
Owner's Addres��s..��((
Owner's E-mail Address
n' L
City
- Telephone
Zip l U'L -116,, —
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City _
State �— Zip �— Telephoner
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip F_ Telephone—
ENGINEER'S NAME
Last First Lic. No.F—
.- .--.---------------
Engineers Address
Engineer's E-mail Address
City
State F Zip Telephoner
CONTRACTOR'S NAME/COMPANY 0 Lic No. F—ClassF—
Y
Contractors Address
Contractor's E-mail Address
City _ _._..
State �— Zip F Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO.\
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. I
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $