HomeMy WebLinkAboutX2021-1904 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application aw
F Comm'I F- Residential City of Newport Beach - Building Division
NOTE PI AN i'NFck FFFS nl IC er nnno nc ci ionnirT�
(`Building F- Grading ('Drainage F Elec F- Mech r Plum cuvdCut [_ cuvdFin
Project Address (Not mailing address) T Flood F Fire F_ Liq F— Landslide F-N/A Floor Suite No
Description of Work
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New/Add SF�Remodel SF �—Garage/New/Add�—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address�
City [`
� State F_ Zip �— Telephone
APPLICANT'S NAME Last
�—
First
Applicant's Address
Applicant's E-mail Address
City
State F�
Zip �— Te one
ARCHITECT/DESIGNER'S NAME
Last
i
Architect/Designer's Address
j�
,. \�\ j F t Lic. No. l
TCfiitectfDesigner's E-mail Address
/i
City
State �—
Zip �— TelephoneF—
ENGINEER'S NAME Last
First— Lic. No.
Engineer's Address
Engineer's E-mail Address
City �
State F
Zip F Telephoner
CONTRACTOR'S NAME/COMPANY
Lic. No. F ClassF_
Contractor's Address
Contractor's E-mail Address
City �—
State F_
—
Zip F_Telephone�
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. -�C
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $