HomeMy WebLinkAboutX2020-0315 - Permit Application (2)Pant 1=orm Worksheet for Combo Building & Solar Permit Application
[ Comm'I residential City of Newport Beach - Building Division /
„� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[]Building ❑ Grading [Drainage ❑ Elec ❑ Mech [] Plum Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing address) ❑ Flood [ Fire [J Liq [ Landslide ❑N/A Floor Suite No)� ( F
Description of
New/Add SF I Remodel SF ( Garage/New/Add [7
Use I Const Type
# Stories i # Units (if Res)[]
Valuation $�
Material/Labor G-1) Cal r! V�
V
OWNER'S NAME Last
��.yt__.
First + _
Owner's Ad
Vjdress
Owner's -mail Address
t l
City
State Zip 2 Telephone
APPLICANT'S NAME Last
First
Applicant's Address,
" -E-mail Address
City
State
I
Zip � � Telephone �
ARCHITECT/DESIGNER'S NAME
Last
First � Lic. No,
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City
State
I
Zip F-I Telephone J
I I
ENGINEER'S NAME Last
I First I Lic. No.
Engineer's Address
Engineer's E-mail Address
City _
I
State
—
Zip Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. Class—�
Contractor's Address
—
I
Contractor's E-mail Address
City
State _
Zip ��j Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $