HomeMy WebLinkAboutX2021-3220 - Permit ApplicationPrint Foim "_1 Worksheet for Combo Building & Solar Permit Application
Comm'I F_ Residential City of Newport Beach - Building Division %20 -52Zc)
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building [ Grading rDrainage F_ Elec r Mech F_ Plum Cu yd Cut Cu Yd Fill F
Project Address (Not mailing address) F7 Flood [ Fire F_ Liq r Landslide F_N/A Floor Suite No
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Description of Work - "_
Use Const Type
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# Stories #Units (if Res)
ValuationF%00� 6)
Material/Labor
New/Add SFI— Remodel SFF Garage/New/Add �—
OWNER'S NAMELast �� First
Owner's Address vOwner's E-mail Address
2 1'`11 _l/� 1_` /✓?/!✓,/�(J °/
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City /1 x// � State Zip Telephone zZq— ro
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
--
City State Zip Telephonel—
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip �— Telephone
ENGINEER'S NAME Last First Lic.'
Engineer's Address Engineer's E-mail Address
City State �� Zip I Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class
Contractor's Address Contractor's E-mail Address
City State F Zip F—Telephone
- - �'"+-trLl • 0868
SETBACKS REAR SETBACKS FRONT PERMIT NO. )
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ CD