HomeMy WebLinkAboutXR2022-2672 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding (- Grading
r-Drainage F Elec r-Mech
r Plum CuydCut F CuydFill
Project Address (Not mailing address) r- Flood
r- Fire r" Liq r- Landslide FN/A Floor Suite No
04 Narcissus
I
Description of Work
Use F—ConstType
32linearft. of 3 ft. tall retaining planter wall (retaining 2 ft.)
# StoriesF_ # Units (if Res)r—
New/Add SF F_
Remodel SFF—Garage/New/Add F—
Valuation $
Material/Labor
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City F
State F__
Zip F— TelephoneF--
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City �—
State F_
Zip F_ TelephoneF_
ARCHITECT/DESIGNER'S NAME Last
First F—Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F
Zip F— TelephoneF_
ENGINEER'S NAME
Last �
First F_ Lic. No.F
Engineer's Address
Engineer's E-mail Address
City F
State �—
Zip F— TelephoneF—
CONTRACTOR'S NAME/COMPANY
Lic. NoT — Class F
Contractor's Address
Contractor's E-mail Address
City �
State F_
Zip I TelephoneF_
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. /, _ Sa
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $