HomeMy WebLinkAboutX2021-1898 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Appl
F comm" FAesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F- Flood F- Fire
F Liq F- Landslide
F_N/A Floor
Suite No
Description of Work
New/Add
SFF_ Garage/New/Add [_
Use ConstType F_
# StoriesF_ # Units (if Res)[_
Valuation$ L�,D
Material/Labor /
OWNER'S NAME �/
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Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last
Applicant's Address
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ARCHITECT/DESIGNER'S NAME
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Architect/Designer's Address
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Applicant's E-mail Address
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First I A n "';i( Lic. No. F—
Architect/Designees E-mail Address
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ENGINEER'S NAME Last kx + (h First
Engineer's Address
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Engineer's E-mail Address
Lic.
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CONTRACTOR'S NAME/COMPANY 1? ' v,k It P'tr-S / ; (� ` Lic No. �j�j�j �, Cli
Contractor's Address
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City Alr� State Fv,
Contractor's E-mail Address
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Zip �� )Telephone
SETBACKS REAR_ SETBACKS FRONT PERMIT N0.
SETBACKS LEFT_ SETBACKS RIGHT �(f `J,(� PLAN CHECK NO. ,/
USE ZONE DEVELOPMENT NO �� 0 L�-O ✓ 16 PLAN CHECK FEES $