HomeMy WebLinkAboutP2021-0510 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Perm', Application
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Cit of New ort Beach - Buildin Division �Z���vS��
F Comm'I F Residential y p g
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_ Grading r-Drainage [_ Elec F_ Mech F Plum
Project Address (Not mailing address) [_ Flood F_ Fire F Liq
Description of Work
New/Add SF Remodel SF Garage/New/Add
Cu Yd Cut
F_ Landslide
Cu Yd Fill F
F_N/A
Floor Suite No
F_ F-
Use Const Type F 7
# StoriesF_ # Units (if Res)F
Valuation $
Material/Labor
APPLICANT'S NAME Last First I
Applicant's Address Applicant's E-mail Address
_..__ _... - -..............
City StateF777
Zip Telephone
ENGINEER'S NAME Last First Lic. No.
-
Engineer's Address Engineer's E-mail Address
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__.__........,�.._.__._..._----..___ _._ .... __._..__._ _._.--.-_- _ ...__ ---. _.._......... _.__ _......._ .._....._ .- .._--..
! Zip Telephone City State F
CONTRACTOR'S NAME/COMPANY �.F� �(XVM pr� Cop%4_ Lic. No. �) � Lr Class
Contractor's Address Contractor's E-mail Address
City ,� A_.. ��Zet� Zip l D).__. Telephone grX�.-.�60.086()
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT PERMIT NO.---__
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SETBACKS RIGHT — PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $