HomeMy WebLinkAboutE2021-0674 - Permit ApplicationI �m Worksheet for Combo Building & Solar Permit Application &i
Comm'I X Residential City of Newport Beach - Building Division
F11NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL "
rBuilding [Grading
rDrainage rElec j Meth
Plum cuydcutF cuvdFin
Project Address (Not mailing address) r Flood
r Firer Liq r', Landslide F_.N/A Floor Suite No
12 Heliotrope
Description of Work
Use F Const Type F_
or sump pump
# Stories # Units (if Res)[
V
Valuation $
New/Add SFs�
Remodel SF F77 Garage/New/Add
Material/Labor
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
....-- ................... ...... ...--.
City
_:... - ......
3 State F
zipTelephoned
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F__
Zip F_Telephoned—
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City
State F_
Zip F_ Telephone
ENGINEER'S NAME
Last 3
FirstF77777 Lic No.
Engineer's Address
Engineer's E-mail Address
City
State -
Zip -, Telephone I
CONTRACTOR'S NAME/COMPANY
Lic. Nof� Class
Contractor's Address
Contractor's E-mail Address
city
State C,
Zip � Telephoned
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. E ZU2,1-0 614
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. O$Ziq — Z
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $