HomeMy WebLinkAboutX2020-0927 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r- Comm'I rK Residential City of Newport Beach - Building Division XZo zo. t9q 2 j
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
RBuilding F_ Grading r`Drainage F Elec FMech r Plum Cu Yd Cut Cu Yd Fill l l
Project Address (Not mailing address) 17 Flood r Fire r"-- Liq r Landslide FN/A Floor Suite No
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Description of Work
Use 'Const Type F—;
#Stories #Units (if Res)
If
Valuation $j�
Material/Labor 4 Ji CUD
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New/Add SF�, Remodel SF� Garage/New/Add —;
OWNER'S NAME Last
S'44D First s4i�
Owner's Address
Owner's E-mail Address
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City
State ZipM� Telephone Z]3o
APPLICANTS NAME Last First c
Applicant's Address
Applicant 's E-mail Address
City I"D
State I l/ Zip %Z Telephone
ARCHITECT/DESIGNER'S NAME
Last '.; First Lic. No.
Architect/Designer's Address
ArchitecUDesigners E-mail Address
City -
StateF777Zip F - -I � Telephoned
ENGINEER'S NAME Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
City �—
State I � Zip j__ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F Class;
Contractors Address
Contractor's E-mail Address
City
State F Zip F Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 7.4'20 • . M7,-7
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $