HomeMy WebLinkAboutX2022-1038 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building r Grading F-Drainage F Elec r Mech F_ Plum Cuvdcutl
Project Address (Not mailing address) F_ Flood r- Fire F- Liq r Landslide
z61 f?t-0-^
Description of Work
New/Add SF Remodel SFF— Garage/New/Add I —
OWNER'S NAME Last
Owner's Address
ek,
city
APPLICANTS NAME Last
L_iEkNtQ� First
Owner's E-mail Address
Cu Yd Fill
rN/A Floor
Suite No
Use �_ ConstType r
# Stories7 # Units (if Res)e—
Valuation
Material/Labor �f
State` Nq Zip Lx� 1 ( 4 Telephone
First
Applicant's Address Applicant's E-mail Address
city I —u v — State F-- Zip �— Telephoi
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City
ENGINEER'S NAME Last
Engineer's Address
City
Last First � I Lic. No. f - --��
Architect/Designees E-mail Aa ress
State F_
Zip r— Telephone[
First I Lic.
Engineer's E-mail Address
State F Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY Lic. No. .� �;bjdf)Class
Contractor's Address Contractor's E-mail Address
City 1'\,t �/ %� State �� Zip €l j Telephone F� ]ti �-:��
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. V n
PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES S