HomeMy WebLinkAboutF2022-0151 - Permit ApplicationVComm'I
(—Building
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division �_-2XII, OV; 1i
F- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I— Grading [7.Drainage F-,. Elec 17 Mech F7 Plum Cu Yd Cut F77 Cu Yd Fill F7
Address (Not mailing
of Work
F-, Flood a. Fire r Liq [71-andslide
F_N/A Floor Suite No
Const Type F77
StoriesF # Units (if Res)7
Valuation $
New/Add SF1 ----------- - ....... - - - Remodel SF177777 Garage/New/Add material/Labor 1777
OWNER'S NAME Last
Owner's Address
First
Owners E-mail Address
cityState
Telephone
. . .... ... .......... . ZIP ------ F_
APPLICANT'S NAME Last
Applicant's Address
....... . - - -------- -
Zip
City F&T7
---
State
First
Applicants E-mail Address
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
I ------------ 17777
Architect/Designers Address
- - ------- -
City State
Architect/Designer's E-mail Address
Zip TelephoneF ........
ENGINEER'S NAME Last First Lic. No
F 1 F77777
Engineer's Address
City State
Engineer's E-mail Address
....... ...... . .. .... ....... . . .. .. ........ . - - -----
Zip Telephone
CONTRACTOR'S NAME/COMPANY
F
[CJ
Lic. No. 1$ 2 Class
Contractor's Address
City State &V
FEW- F
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
ZipF _: Telephone
PERMIT NO.
PLAN CHECK NO.