HomeMy WebLinkAboutX2022-1437 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm] r' Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building r Grading rDrainage rElec i—Mech F- Plum CuvdCut F CUYdUlf
Project Address (Not mailing address) F_ Flood r Fire i— Liq r Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType F_
# StoriesF_ # Units (if Res)F_
Valuation $
New/AddSFF__ Remodel SFF Garra�ag—e/New/Add
Material/Labor
—OWNER'S NAME Last
�33 5L/3 �S7 zi✓%4N/(L/S First
Owner's Address
Owner's E-mail Address
lC C 55 -r9V11ve
/33o I
City C 4
State I % ZipFfZ_4,,k Telephone
APPLICANT'S NAME Last First
Applicant's Address
Applicant's E-mail Address
City
State F— Zip F— Telephoned
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City �—
State F___ Zip F_ Telephoned
ENGINEER'S NAME Last First F_ Lic. No.r—
Engineer's Address
Engineer's E-mail Address
City �
State F_ Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City
State F_— Zip Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NOPMM • 74M
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $