HomeMy WebLinkAboutX2020-2927 - Permit ApplicationPrint Form - . I Workoheet for Gorrnlh)o '-' Iuoic 4iig - olar Permit Application�WP°Rr
F Comm] F Residential
City of Newport Beach - Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F Building F_ Grading
F—Drainage [_ Elec Mech F Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F Landslide I_N/A Floor Suite No
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- F i
Description of Work
Use Const Type F
# Stories e # Units (if Res)e_
Valuation $
Material/Lab ��� ��
New/Add SF
r
Remodel SF lu Garage/New/Add
OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
City
State F Zip Telephone[
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State ZipTelephone
ENGINEER'S NAME
Last First Lic. No.e
Engineer's Address
Engineer's E-mail Address
City
State Zip Telephone
eONTRACTOR'S NAME/COMPANY �J f v��5/��� � f �^ Lic. No. S� ?v Class
Contractor's Address
Contractor's E-mail Address
City
State f (% Zip Telephone (Ie "z
SETBACKS REAR
SETBACKS FRONT PERMIT NWUW&U%r,01 •`rise
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT ► PLAN CHECK FEE
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