HomeMy WebLinkAboutX2021-1013 - Permit Application (2)x2�zi-�o►�
Print For Worksheet for Combo Building & Solar Permit pplication
F_ Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c<'o,�•�
Building rGrading
rDrainage [_Elec rMech -Plum cu Yd c,tCu Yd Filll
Project Address (Not mailing address) rI Flood f- Fire I Liq F- Landslide r7N/A Floor Suite No
Description of Work
Use Const Type F_
# Stories # Units (if Res)[
Valuation $
Material/Labor
New/Add SFF_
r-----
Remodel SF Garage/New/Add I
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
... .....State F..----.. Zip Telephone—
APPLICANT'S NAME
Last- — First
Applicant's Address
Applicant's E-mail Address
City
State F_ Zip F Telephone
ARCHITECT/DESIGNER'S NAME Last First —! Lic. NoT---,
Architect/Designer's Address
Architect/Designer's E-mail Address
City _._
State F___ .Zip F Telephone
ENGINEER'S NAME
Last First �— - Lic. No.F
Engineer's Address
Engineer's E-mail Address,
I
City _ _...
_.. _ .: State r ZIP I Telephone ' -
CONTRACTOR'S NAME/COMPANY Lic No. 'tt'!�/?j Class
Contractor's Address
Contractor's E-mail Addr
AddressP730076676
/6
City _
--
State F_ Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
6
DEVELOPMENT NO PLAN CHECK FEES $