HomeMy WebLinkAboutX2021-0499 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application
r Comm'I F_ Residential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building r Grading
j"Drainage r Elec F_ Mech
F- Plum CuvdCut l CuYdFill
Project Address (Not mailing address) F Flood F_ Fire [— Liq F_ Landslide rN/A Floor Suite No
r
Description of Work
Use F—Const Type F--
# Storiesr— # Units (if Res)F—
Valuation S
Material/Labor
New/Add SFF _-_ Remodel SF f Ga a ew/Add l r
OWNER'S NAME
Last �\��
First
Owner's Address
_
Owner's E-mail Address
City �—
State F_
Zip F— Telephoned
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E Address
City
State
Zip TelephoneF
ARCHITECT/DESIGNER'S NAME Last
First Lic. No. � �-
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State F—
----
Zip Telephoned
ENGINEER'S NAME
Lastrnr� , _
v,!
First ��` Lic.1.l t'tA t
' ` w
Engineer's Address
Engineer's E-ma Il Address
City
State
Zip Telephone
CONTRACTOR'S NAME/COMPANY
Lic. Class
Contractor's Address
Contractors E-mail Address
City �
State I
Zip F_ Telephoner —
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FE S