HomeMy WebLinkAboutM2021-0020 - 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
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Project Address (Not mailing address) F Flood r Fire r Liq r Landslide FN/A FI Suite No
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Description of Work
use F—Const Type F
# Stories #Units (if Res)
Valuation 5
Material/Labor i��50
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New/Add SFF Remodel SF I ] r) Garage/New/Add
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OWNER'S NAME Last First l�
Owner's Address Owner's E-mail Address
City t. State l i� Zip - Telephone --�)
APPLICANT'S NAME Last First
V oplicant's Address Applicant's E-mail Address
City F— State F— Zip F TelephoneF
ARCHITECT/DESIGNER'S NAME Last First Au Lic. No. E..1
Architect/Designer's Address Architect/Designer's E-mail Address
City i State Zip Telephone
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ENGINEER'S NAME Last Z ) -C First �������,i�' Lic. No ,� j�
Engiinnteer's Address Engineer's E-mail Address
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City ! nl/j,� State 4 C b Zip ' �(,�,Cy Telephone
CONTRACTOR'S NAME/COMPANY Lic No. F ClassF
Contractor's Address Contractor's E-mail Address
City State F Zip F TelephoneF
SETBACKS FRONT PERMIT NO.7�2� - (G�
SETBAC5LEF
SETBA ' SETBACKS RIGHT PLAN CHECK NO. NOS D-USE
% DEVELOPMENT NO PLAN CHECK FEES $