HomeMy WebLinkAboutX2021-1013 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit pplication
Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F_ Grading
v
F -Drainage F_Elec rMech f -Plum CuvdCut CuvdFill
Project Address (Not mailing address) F! Flood F- Fire F Liq f- Landslide N/A Floor Suite No
F r
Description of Work
Use Const Type F_
# Stories[ # Units (if Res) -
Valuation $
Material/Labor
New/Add SF�— Remodel SF�—
Garage/New/Add F—
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
.....State L.-..__ Zip [— Telephoner _......
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
_. .....State
Zip r- TelePhoneF_._.-.._
ARCHITECT/DESIGNER'S NAME
Last
First Lic. No.
Architect/Designer's Address
ArchitecttDesigner's E-mail Address
city
State -
Zip r._- Telephone [_
ENGINEER'S NAME
Last
First Lic No. F_
Engineer's Address
Engineer's E-mail Address,
City .,
State F_
Zip F Telephoner
CONTRACTOR'S NAME/COMPANY
Lic No. W7713 Classy
Contractor's Address
Contractor's E-mail Address P730)76676
City
State F—
Zip �— Telephone[�
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
a
PLAN CHECK FEES $