HomeMy WebLinkAbout2241-2021 - Permit ApplicationA vtr vl' "/�V/ 0i
Print Form Worksheet for Combo Building & Solar Permit Application oF��°°�
I- Comm'1 r Residential City of Newport Beach - Building Division E
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c<',os'
[-"Building F_ Grading
r -Drainage rElec j`Mech 1 -Plum CuvdCut cuvdFill
Project Address (Not mailing address) r- Flood F- Fire F- Liq r Landslide rN/A Floor Suite No
Description of Work
Use F— Const Type
# Stories #Units (if Res)
i
`aluation$
Material/Labo
I--
New/Add SF
Remodel SF I _---- Gara a/New/Add r— --
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
_. StateF--.. ZIP [� Telephoned_._
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State �---_Zip F— Telephone—
ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No. f -'
Architect/Designer's.Address
Architect/Designees E-mail Address
.City I
_ State F_— ZiPr --- Telephoner —
ENGINEER'S NAME .Last
First F_- Lic. No. r -
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip -_ Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. WmClassFX
Contractor's Address
Contractor's E-mail Address
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City
State FC:-- Zip -60 Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT N0. =
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. P f P
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $