HomeMy WebLinkAboutXC2023-0224 - Permit ApplicationPrint Form Worksheet for Combo Buii Iding $ Solar Permit Aimlicatir)n
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F Comm'I F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TI
ME OF SUBMI I UAL
F—Building F- Grading
FDrainage F—Elec FMech r Plum Cu Yd Cut Cu Yd Fill
ProjectAddress (Not mailing addr
ss) F- Flood F- Fire F- Liq F— Landslide F-N/A
Flo
r
Description of Work
GIB
Use C
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# 5toriesr
1
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
�—Zip � Telephone�—
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State
�— Zip I TelephoneF —
ARCHITECT/DESIGNER'S NAME
Last
First �—
ArchitecUDesigner's Address
Lic. No.
ArchitecUDesigner's E-mail Address
City
State
�— Zip �— Telephone�—
ENGINEER'S NAME
Last
First F —
Engineer's Address
Lic No.j
Engineer's E-mail Address
City
State
�— Zip �— Telephone�—
CONTRACTOR'S NAME/COMPANY
Lic No. �—
Contractor's Address
Contractor's E-mail Address
City �—
State F—
Zip F—Telephone�—
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK
1SE ZONE
DEVELOPMENT
NO.
NO PLAN CHECK FEES $
or Suite No
Type �-
# Units (if Res)