HomeMy WebLinkAboutX2020-1203 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit ApphceAon o�aEWPoRT
F Comm'I F_ Residential City of Newport Beach - Building Division xu lam/ D li
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �q�r
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C/PORN
(Building F_ Grading j`Drainage F-Elec F`Mech [- Plum CuvdCut l` CuYdFill
Project Address (Not mailing address) F_ Flood r Fire F_ Liq r' Landslide FN/A Floor Suite No
deop F
Description of Work
Use Const Type
!q M , K �[�
# StoriesF # Units (if Res)
Valuation $
New/Add SF Remodel SF Garage/New/Add F— Material/Labor
OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
--- --
City State Zip �_� Telephone[
APPLICANT'S NAME Last �— First
Applicant's Address Applicant's E-mail Address
City I State F_ Zip [_ Telephonel
—
ARCHITECT/DESIGNER'S NAME Last
First �_ Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
CityState _ Zip Telephone
ENGINEER'S NAME Last First Lic. No.e
Engineer's Address Engineer's E-mail Address
City I State F_ Zip [__ Telephone
____._._ � u.,-.-,
CONTRACTOR'S NAME/COMPANY � � I � _ Lic. No. �J Class
Contractor's Address Contractor's E-mail Address
City
SETBACKS REAR
SETBACKS LEFT
State Zip [ Telephone
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO. PIS I -I hl"6
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $