HomeMy WebLinkAboutU2024-5225 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ,F���rm
City of Newport Beach - Building Division U
F Comml � Residential 1s
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G. , '
rBuilding r Grading
rDrainage r Elec r Mech
r Plum CuydCut CuYdFill
Project Address (Not mailing address) F_ Flood
r• Fire j— Liq j— Landslide F_N/A Floor Suite No
04 Narcissus
I— I
Description of Work
Use t ConstType t
gas line forfire pit
# Storiest #Units (if Rest
New/AddSFt
RemodelSFF— Garage/New/AddF
Valuation $
Material/Labor
OWNER'SNAME
Last—
First
Owner's Address
Owner's E-mail Address
City �
State F_
Zip F— TelephoneF_
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F_
Zip I Telephoned
ARCHITECT/DESIGNER'S NAME Last
First 7— Lic. No. F—
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City
State F_
Zip F Telephonet
ENGINEER'S NAME
Last
First [_ Lic. No.t
Engineer's Address
Engineer's E-mail Address
City
State �
Zip � Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. Class t
(Contractor's Address
Contractor's E-mail Address
I
City
State F—
Zip F— TelephoneF_
—SZZ S
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. U 70 (�/
��
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. Zo G Z 2s07
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $