HomeMy WebLinkAboutX2022-1222 - Permit ApplicationI_ _ Residential Comm'I Print Form p Worksheet for Combo Building & Solar Permit Application DMWF�AiN.1�Ci of New ort Beach - Buildin Division rNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_ Grading j—Drainage F_Elec FMach r—Plum Cu vd Cutl Cu Yd Fill
Project Address (Not mailing address) f- Flood F_ Fire F_ Liq r Landslide F_N/A Floor Suite No
Description of Work
Use F Const Type r
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# Stories # Units (if Res)s
Valuation $
Material/Cabo J
New/Add SF�— Remodel SF Garage/New/Add �—
OWNER'S NAME LastFC First r—
Owner's Address
Owner's E-mail Address
City State �— Zip Telephones —
APPLICANT'S NAME Last s.. First
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Applicant's Address Applicant's E-mail Address
City .r �` Zi ;' —, Tele hone Z, �C�{ ?'"'
State \� P 1 P ' 2��
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ARCHITECT/DESIGNER'S NAME Last First F — Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip �— Telephones
ENGINEER'S NAME Last i _ First
iceF��-� Lic. No. —�
Engineer's Address Engineer's E-mail Address
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City FA ®� State F-® —
\ Zip �; Telephoned-.
CONTRACTOR'S NAME/COMPANY Lic. No. FT 06 Class f s
Contractor's Address Contractor's E-mail Address
City State �— Zip F_ Telephones
SETBACKS REAR SETBACKS FRONT PERMIT NO. Z* ZZ ZZZ
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Z / • 2Z
USE ZONE DEVELOPMENT NO PLAN CHECK FEES$