HomeMy WebLinkAboutX2021-1011 - Permit ApplicationPrint FormWorksheet for Combo Building & Solar Permit Application
s Comm'I [ Residential :W i; City of Newport Beach - Building Division 6 2-O K s
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL vo co k J
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Project Address (Not
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Description of Work
Use �, Const Type
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# Stories # Units (if Res)s
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Valuation $
Material/Labor
New/Add SF
Remodel SF Garage/New/Add
OWNER'S NAME
Last 1471���- ` [,g,14Ffrst
Owner's Adrrd,,,,ress
Owner's E-mail Address
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City
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State sCi� Zip 2 pZ, Telephone—
APPLICANT'S NAME
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Laster First Lic. No.
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Architect/Designer's Address
Architect/Designer's E-mail Address
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City
State y zipfF7 Telephone '
NGINEER'S NAME
Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
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State s� Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. G �' lass��
Contractor's Address
Contractor's E-mail Address
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City
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SETBACKS REAR__
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $