HomeMy WebLinkAboutX2022-0024 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application
Vomm'I F_ LIR6sidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL u
wilding F_ Grading
F-Drainage F_ Elec F_Mech F— Plum CuYd Cut Cu Yd Fill F
Project Address (Not mailing address) f Flood r Fire r Liq r Landslide F_N/A Floor Suite No
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Description of Work
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# StoriesF I— # Units (if Res)F
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New/Add SF
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R SF Garage/New/Add
T. - l-,� e/New/Add
Valuation $ y
Material/Labor �(�!/•
OWNER'S NAME
Last 12-(11A,,� First I Co
Owner's Address
Owner's E_maiLAddrsss
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State �— Zip TelephoneF
APPLICANT'S NAME
Last ')Z-(/Jl ->L First JA
Applicant's Address
Applicant's E-mail Address
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City
/JD State — Zip %2(� 2 Telephone �P - �t� � i
ARCHITECT/DESIGNER'S NAME Last I A clulf-/Lj First /7.4/t/D y/ Lic. N .
Architect/Designer's Address
Architect/Designees E-mail Address
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City
State Zipf--__� TelephoneF_
ENGINEER'S NAME
Last First �® Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City I
State Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY65, Lic. .N
Contractor's Address
actor's E-mail Address
City
State Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. ZvZL
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. ) L l
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USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $