HomeMy WebLinkAboutX2022-1528 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application @,Sw �RrF_ Comm'I F_ Residential
City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI'—
F_ Building r Grading FDrainage F_ Elec r Mech r plum CuydCut l CuvdFill F_
Project Address (Not mailing address) F_ Flood r Fire r" Liq r" Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType
NeuJ Ct' I SIS �n� wh
cell
t4ei s # Units (if Res)F—
New/Add SF� Remodel SF�—
Garage/New/Add �—
ion $
ValuatOOQ
Material/Labor
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OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State �—
Zip F— Telephone[ —
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City I State �—
Zip [_ TelephoneF_
ARCHITECT/DESIGNER'S NAME Last
First F_
Lic. No. F_
Architect'Designer's Address
Architect/Designer's E-mail Address
City I State
Zip _ Telephoned
ENGINEER'S NAME Last
First F_ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State
Zip r- Telephone[
CONTRACTOR'S NAME/COMPANY
Lic. No. �— ClassF_
Contractor's Address
Contractor's E-mail Address -
City State F
Zip F_ Telephone[ —
SETBACKS REAR SETBACKS FRONT
PERMIT NO. -r- -- -- - I#
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE _ DEVELOPMENT NO
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