HomeMy WebLinkAboutX2021-1513 - Permit ApplicationI
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Print Form ` Worksheet for Combo Building & Solar Permit Application ��`" yam
F Comm'I r` Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5<',0,+"
F -Building F_ Grading [7Drainage F_Elec rMech rPlum Cu Yd Cut', Cu Yd Fill)
Project Addres (Not mailing address) F- Floo(dl F_ Fire F- Liq F Landslide F_N/A FloorSuite No
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#Stories #Units (if Res)r—
Valuation
New/Add SF7 Remodel SF�--- Gara a/New/Add �^�
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Material/Labor (� J
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�Fj 7( ' First
ner's Address
Owner's E-mail Address
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State StateXTelephone[
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City
State r---- Zip F Telephone--
ARCHITECT/DESIGNER'S NAME
Last FirstF ___---
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City _.
State F------ Zip I . TelephoneF�
ENGINEER'S NAME Last
First f — ---- - - Lic NoT —
Engineer's Address
Engineer's E-mail Address
City
—
State Zip F— Telephoner
CONTRACTOR'S NAME/COMPANY
Lic. No. r- Class!
Contractor's Address
Contractor's E-mail Address
City
State F Zip Telephoner ---
SETBACKS REAR
SETBACKS FRONT PERMIT NO. �Cyv (/t, — L ✓��
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. I �j ZS vt
USE ZONE
DEVELOPMENT NO '(J ZOV PIAN CHECK FEES $