HomeMy WebLinkAboutX2020-2882 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application T"a
City of Newport Beach - Building Division
Comm'I j- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F71B`uiIding r- Grading rDrainage F_ Elec r Mech
r Plum CuvdCut F_ CuYdFill F_
Project Address (Not mailing address) r Flood
r Fire F_ Liq j- Landslide F_N/A Floor Suite No
Description of Work
Use vonstType
A
r-
# Stories' #Units (if Res)
Valuation $
Material/Labor
New/Add SF F -�� Remodel SF 4� *S Garage/New/Add F__
OWNER'S NAME Last Mo&rl r f
First
Owner's Address
Owner's E-mail Address
City � State F_
Zip [— Telephoned
APPLICANT'S NAME Last C e ,
First 1 !`^ C-'
Applicant's Address
Applicant's E-mail Address
/00
City �R5 (� ca /l State
Zip I Telephone��
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State �
Zip F Telephoned
ENGINEER'S NAME Last
First F_ Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City State F
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. f-f Class l 15
Contractor's Address
Contractor's E-mail Address
City State �—
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. b
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N .
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $