HomeMy WebLinkAboutXR2022-1853 - Permit ApplicationPrint Forn, Worksheet for Combo Building & Solar Permit Application
F Comm'I l Residential City of Newport Beach - Building Division
yt NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I A Building Grading Vrainage V_ Elec Mech V Plum
Cu Yd Cut Cu Yd Fill I
Project Address (Not mailing address) I— Flood f Fire F_ Liq F Landslide FN/A Floor Suit N
cription of Work
New/Add SFPt(oD Remodel SF
OWNER'S NAME
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City Aw
Last
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State
APPLICANT'S NAME Last
Applicant's Address
City
ARCHITECT/DESIGNER'S NAME
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Garage/New/Add `6^l
First �—
Owner's E-mail Address
Zip I r b Telepho
First Kroll,
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Use Const Type F
# Stories[z # Units (if Res)T
Valuation$ F-70,coo
Material/Labor
Applicant's E-mail Address
Sta%ee) ZIP I OF / / S� V Telephone Z: 0
Last PTi(F66 First D(RW Lic. No
e
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City State F_ Zip Telephone F�
ENGINEER'SNAME Lastl
First F� Lic No.F�
Engineer's Address Engineer's E-mail Address
City State F_ Zip jTelephoned--
CONTRACTOR'S NAME/COMPANY —
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Contractor's Address Contractor's E-mail Address
City State F_ Zip �— Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
13i • Jtf'� PLAN CHECK NO. ,�.Zv21-• �'10
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