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HomeMy WebLinkAboutPV2020-034 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application j- Comm'I � Residential City of Newport Beach - Building Division p�� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building F_ Grading rDrainage rElec (—Mech F— Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) F_ Flood F— Fire F_ Liq r"- Landslide rN/A Floor Suite No Description of Work ( ' U Use Const Type ��' QLI'i D �fti0 # Stories #Units (if Res)[_ Valuation $ New/Add SFF Remodel SFF— Garage/New/Add I----' Material/Labor OWNER'S NAME Last First Owner's Address Owner's E-mail Address City _State F_—._. Zip F,. Telephone--.... APPLICANT'S NAME Last F First Applicant's Address Applicant's E-mail Address City State F_ Zip F_ Telephoned—' ARCHITECT/DESIGNER'S NAME Last First [_ Lic. No. F— Architect/Designer's Address Architect/Designer's E-mail Address City _ — State F_ Zip F__.. Telephone ENGINEER'S NAME Last FirstF_Lic. No.F_' Engineer's Address Engineer's E-mail Address City _ State r Zip Telephoner-.-.---.-.------ No. OClass CONTRACTOR'S NAME/COMPANY Licg W "I Contractor's Address Contractor's E-mail Address �n �J �'pC..•,D U�p 1,0). �—ftA Cityvv Y , State Zip Telephone p SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $