HomeMy WebLinkAboutX2021-1976 - Permit ApplicationX ac k -1
Print Form Worksheet for Combo Building & Solar Permit Application o° Ea rm
( Comm'I Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(—Building Grading
F Drainage I_ Elec r Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F Flood (" Fire F- Liq F Landslide F_N/A Floor Suite No
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Description of Work
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Use F_ Const Typ
# Stories # Units (if Res)
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New/Add SF
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Remodel SF Garage/New dd �
Valuation $
Material/Labor
OW R l�`�
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Owne r ss
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Owner's E-mail Address
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City
State Zip FW Telephoned
APPLICANT'S NAME
Last F— Firsl 1�
Applicant's Address
Applicant's - ail Address 7"
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City
State Zip F Telephone 1
ARCHITECT/DESIGNER'S NAME Last
First Fs Lic. No. r�
Architect/Designer's Address
Architect/Designees E-mail Address
Zip [_ Telephoned
City �
State
ENGINEER'S NAME
Last �.*♦ First Lic No
Engineer's Address
Engineer's E-mail Address
..
City
State � Zip F_ Telephone F_
CONTRACTOR'S NAME/COMPANY
�— Lic. No. 1 Classy
Contractor's Address
Contractor's E-mail Address
City -��I (�,i
State '5 Zip Telephone ,�(�
1
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $