HomeMy WebLinkAboutX2022-0732 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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City of Newport Beach - Building Division Comm'I ( Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL a9
Building r Grading
F-Drainage F_ Elec F Mech
F- Plum Cu vd Cut Cu Yd Fill F_
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq r Landslide FN/AFloorr Suite No
1855 �et;R
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Description of Work
Use F—ConstType
2-t�ct�. Qom.;rS
Sr. eoctj
#Stories #Units (if Res)
go
Valuation $
Material/Labor F3100c)
New/Add SF� Remodel SF f — Garage/New/Add F
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City I
State �-
Zip [_ TelephoneF_
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F_
Zip F TelephoneF_
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City
State F_—
Zip F_ TelephoneF_
ENGINEER'S NAME
Last
First Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State �—
Zip Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City
State F
Zip F Telephone F_
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $