HomeMy WebLinkAboutX2021-2127 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailin address
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Floor
Suite Nolu
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Use Const Type
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Remodel SFs----' Garage/New/Add valuation
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OWNER'S NAME Last
MZI"M777 First
Owner's Address
Owner's E-mail Address
City
APPLICANT'S NAME
/,pplicanhs Address
Last
State
r.'....I Zip
First l..... I fiv
Applicant's E-mail Address
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City`J State I 1 IYT
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ARCHITECT/DESIGNER'S NAME Last p
First
F— Lic. No.
Architect/Designer's Address
6,D0 ' Archite
cVDesigner's E-mail Address
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City State Zip F— Telephoned _.
ENGINEER'S NAME Last F__—
First F�- Lic. No.�—'
Engineer's Address
Engineer's E-mail Address
City State —Zip _...:
�- Telephone—
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CONTRACTOR'S NAMEXOMPANY
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Contractor's Address
E-mailAddress
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. �
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USEZONE DEVELOPMENT NO
PLAN CHECK FEES $