HomeMy WebLinkAboutX2020-1214 - Permit ApplicationIzm
Print Form Worksheet for Combo Building & Solar Permit Application as'..
Comm'I Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[!Building F-'•Grading I —Drainage Elec
[,Plum Cu Yd Cut FCu Yd Fill
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Project Address (Not mailing
addre j Flood° Fire 0Liq [—Landslide FN/A Floor Suite No
Description of Work
Use F7 ConstType
(✓
# Stories!, # Units (if Res) ._ �..
Ste✓ 'i
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L
Valuation $
Material/Labor �/
--------
New/Add SF, Remodel SF—'
Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
Sta e
_ Zip Telephoned;
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City
', State
--,
Zip F_!, 'FelephoneF—'
ARCHITECT/DESIGNER'S NAME
Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
i
City
�'�State F
Zip F—�, Telephoner
ENGINEER'S NAME Last
-_
-_'. First Lic. No.�
Engineer's Address
Engineer's E-mail Address
city
State �—
Zip F' Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F—Class F—
Contractor's Address
Contractor's E-mail Address
City
State r
Zip Telephoner
_-
10 77
SETBACKS REAR
SETBACKS FRONT
PERMIT/f O. X -'n I Ll
SETBACKS LEFT _
SETBACKS RIGHT
PLAN HECK NO.��y
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
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