HomeMy WebLinkAboutX2021-0138 - Permit ApplicationWorksheet for BLlfiding Combo Permit AppJiication
Comm'I Residential City of Newport Beach -. Building Division
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBIv11TTAL
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Project Address (Not rnaffing addrass)
Description of Work
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OWNER'S NAME Last
First
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Floor Suite No
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Valuation $
Matteerialotl/Labor
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last First 1111104
Applicant's Address
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City EH o -I 't —� State E
Applicant's E-mail Address
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ARCHMECT/DESIGNER'S NAME: Last Llc, No. G
Amhitedt/Deslgnar's Address I 11F Architect/DeslgLneerr's`E--`m"a'ill Addre—srl j
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ENGINEER'S NAME Last First LIc.No.�
Englneer's Address
City -- State
Englnsar's E-mail Address -
ZIPTelephone
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CONTRACTOR'SNAMEXOMPIANY LlcNo. Clast
Contractor's Address NA M_:A w
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City (-- State
ENERGY P/C FEE $
GRADING PIC FEE $
ELEC/PLUIWIvIECH PIC FEE $
-. Contractoes E-mail Address _
ZipJ Telephone
FIRE P/C FEE $ PERMIT NO.
PLANNING P/C PEE $ PLAN CHECK NO.
PLAN CHECK FEE $