HomeMy WebLinkAboutX2017-3052 - Permit ApplicationX, �_ok-7 . ?,orO 2
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Worksheet for Combo Building & Solar Permit Application
F- Comm'I r Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building [Grading
r7Drainage F_Elec F_Mech F- Plum Cu Yd CutF Cu Yd Fill
Project Address (Not mailing address) C Flood j— Fire r Liq (- Landslide rN/A Floor Suite No
Description of Work
I
Use �, Const Type
#Stories
Valuatio
New/Add SFF -
Remodel SF \ U
a e/New/Add
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Mater,
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.
State F
Zip—'. Telephone
ARCHITECT/DESIGNER'S NAME Last
First F Lic. No.
ArchitectlDesigner's Address
ArchitecUDesigner•s E-mail Address
City
State F—
-
Zip F— Telephoned
ENGINEER'S NAME
Last
First F Lic. NoF
Engineer's Address
Engineer's E-mail Address
City
State-',
Zip Telephoned.
CONTRACTOR'S NAME/COMPANY
Lic. No. �i, Class
Contractor's Address
Contractor's E-mail Address
City
State F_ —Zip
F Telephone,
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $