HomeMy WebLinkAboutX2022-1198 - Permit ApplicationPrint Form Residential City Worksheet for Combo Building & Solar Permit Ap lic
�ation
I�" Comm'I Rr
j1
gWPp
�" y of Newport Beach -Building Division �,���„� � 61CL
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL u
F—Building
g Grading F-Drainage f` Elec j Mech
j�` Plum Cu Yd Cut Cu Yd Fill F_
Project Address (Not mailing ddres Flood F Fire l_ Liq f_ Landslide F_N/A
Floor Suite No
Description of Work
FUse Const Type
s[ # Units (if Res)[—
New/Add SF
Remodel SF Garage/New/Add F— Valuation $
Material/Labor
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City �.._...._...�
State F_
Zip F— Telephone���Y�
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State Zip TelephoneF _
I
ARCHITECT/DESIGNER'S NAME -� -
Last -' First
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip F_ Telephone
ENGINEER'S NAME
Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
Fy
State Zip _ Telephone
VTRACTOR'S NAME/COMPANY
Lic. No. � Class
actor's Address
`
/-, / `� \ 6`
Contractor's E-mail Address (J U LJ
State f Zip � Telephoner�
S REAR
SETBACKS FRONT
PERMIT NO.
LEFT
SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $
Z