HomeMy WebLinkAboutX2021-3128 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F comm'I Fz-,, �eidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
RFl� I e c Mech [UP1'6`n1 F
FUK,,dIng F_ Grading F—Drainage Cu Yd Cut - Cu Yd Fill
Project Address (Not mailing address) r— Flood F_ Fire f— Liq F_ Landslide FN/A Floor Suite No
i F_
- .... .,.._ 11--.1.1 ..... .. . ........
Description of Work
Use Const Type
# StoriesF #Units (if Res)
Valuation $
New/Add SF Remodel SF Garage/New/Add
Material/Labor
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
........ .. .. ... .
City Zip P State F Telephone[_16
APPLICANT'S NAME Last f First
Applicant's Address Applicant's E-mail Address
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City A..State Zip Telephone[ 71144
.... ... ... ... ... ... ....
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City . .. ... State Zip[ Telephone
ENGINEER'S NAME Last First F Lic. No.1,
Engineer's Address Engineer's E-mail Address
City State zip F Telephonel,
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor's E-mail Address
City 4 State Telephone[ 41V,45 3:W 2-4
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $