HomeMy WebLinkAboutX2020-2730 - Permit Application",",'Worksheet for Combo Bu(roing & Solar Permit Application
[ Comm'I [i Resi��i� , 7 �7 0 City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL C
❑Building [Grading []Drainage ❑Flet [Meth [Plum Cu yd cut Cu Yd Fill
Project Address (Not mailing address) G Flood ❑Fire [] Liq [Landslide ❑N/A Floor Suite No
Description of Work Use L 7" Const Type
# Stories # Units (if Res)r
Valuation $
New/Add SF Remodel SF� Garage/New/Add Material/Labor
OWNER'S NAME Last t First
Owner's Address Owner's E-mail Address
F ----------
City I State I � Zip F Telephone
APPLICANT'S NAME Last I First
Applicant's Address
City State F-7
Applicant's E-mail Address
Zip [77777 Telephone
�—
ARCH ITECT/DESIGNER'S NAME Last �— First Lic. No.
Architect(Designer's Address
City State
Architect/Designer's E-mail Address
Zip Telephoned
ENGINEER'S NAME Last �— First F77777 Lic. No:F--
Engineer's Address
City State �—
-- -- —
Engineer's E-mail Address
Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY -Lath Lic. No. L�f�ja Class
Contractor's Address Contractor's E-mail Address
City State �- Zip Telephoner
SETBACKS REAR SETBACKS FRONT PERMIT NO:;Au
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2-A 00 .-020
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $