HomeMy WebLinkAboutX2022-1386 - Permit ApplicationPrint F Form Worksheet for Combo Building & Solar Permit Application
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Comm'I F_ Residential City of Newport Beach - Building Division tj
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM16TA*1'� x
F -Building Grading F -Drainage F_ Elec Mech F_-, Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F Flood F__ Fire F_ Liq F_ Landslide F_N/A Floor Suite No
F
_- - -------
Description of WorkUse F ConstType F
13+u( StoriesF_ # Units (if Res)F—
Valuation $
New/Add SF[77777 Remodel SFF_,CT_L)_Garage/New/AddF_ Material/Labor
OWNER'S NAME Last
Owner's Address
City State
APPLICANT'S NAME Last
Applicant's Address
I- - - - - - --- -- - - - -_ ... . .....
City I State
First
Owner's E-mail Address
------ - - - --------- ------- .. ....
Zip
First
Applicant's E-mail Address
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zip TelephoneF777777
ARCHITECT/DESIGNER'S NAME Last First Lic. No.F__
Architect/Designer's Address
City State
Architect/Designer's E-mail Address
Zip TelephoneF
ENGINEER'S NAME Last F7777777777 First F77777 Lic. No.F-,
Engineer's Address
city F State
Engineer's E-mail Address
Zip TelephoneF
CONTRACTOR'S NAME/COMPANY Lic. Nof_�q7-30`
Contractor's Address
City State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
Zip Telephone[
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $