HomeMy WebLinkAboutX2021-3282 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
Comm] F— Residential City of Newport Beach - Building Division Y o
NOTE: PLAN CHECK FEES DtJF AT TInnF nP .cI IWvllTTA
... I
j—Building F_Grading f—Drainage j—Elec Mach F_PlumcuvdCut F_ CuYdFill
l
Project Address (Not mailing address) F_ Flood
r Fire F_ Liq F_ Landslide F_N/A( Fioorr Suite No
F_ r_—_
Description of Work
Use ConstType i s
# StoriesF. # Units (if Res)[—
Valuation $
Material/Labor
New/Add SF 1 Remodel SF�—
Garage/New/Add �—
OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
City State �— Zip F— Telepho
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F
Zip F— Telephoner
ARCHITECT/DESIGNER'S NAME Last
First
Lic. No. F—
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City State F_
Zip �— Telephonel
ENGINEER'S NAME Last F
® First Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City .-----__, State F
\
Zip F— Telephone[—
CONTRACTOR'S NAME/COMPANY �� , �� �j
Lic No.� ��. [lass ;r
Contra %%
C'�ractor's E-mail Address
City �' ` State
Zip Ff Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO,
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $