HomeMy WebLinkAboutX2020-1985 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application o�2EWp°Re
CommI j` Residential
City of Newport Beach - Building DivisionwzU 11qjNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI 9< pP
j—Building r- Grading
(Drainage r-Elec F_ Mech j" Plum CuYdCut F CuYdFill F
Project Address (Not mailing address) r Flood F_ Fire j— Liq j` Landslide J—N/A Floor Suite No
2 I(, I M -s"._ o �.- --- I
Description of Work
Use F ConstType
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csr w !
# Stories # Units (if Res)-
_
Valuation $ r �(� C%
Material/Labor
New/Add SF
Remodel SF �� w Garage/New/Add ` '
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City F_
State Zip Telephone
APPLICANT'S NAME
Last ��� ` First
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Applicant's Address
Applicant's E-mail Address
City
State Zip j Telephone j 7 M)? -- ® s n
ARCHITECT/DESIGNER'S NAME Last First I Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip Telephoned
ENGINEER'S NAME
Last First Lic. No.�
Engineer's Address
Engineer's E-mail Address
City
State F Zip Telephone��
CONTRACTOR'S NAME/COMPANY Lic. No. F,— Class F
Contractor's Address
Contractor's E-mail Address
City
State Zip Telephoned_-v'
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
—2�444
SETBACKS LEFT
—ey2—<3— b
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $