HomeMy WebLinkAboutX2022-0734 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division fi
Comm'I j- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Uc,.._-.•
r Building r Grading
F-Drainage rElec F Mech F- Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F Flood F_ Fire F_ Liq r- Landslide F_N/A Floor Suite No
&5_ Sk(5r
c&cP— F 3 os3a3
Description of Work
Use F—Const Type �-
aCK
# StoriesF_ # Units (if Res)[
Valuation $
Material/Labor ?j1000
New/AddSFF_
Remodel SF F_Garage/New/Add —
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City �
State F— Zip I Telephone
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State �— Zip F Telephoned
ARCHITECT/DESIGNER'S NAME
Last First I
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip F_ TelephoneF_
ENGINEER'S NAME
Last First 7— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F® Zip F Telephone[ —
CONTRACTOR'S NAME/COMPANY
Lic No. �— Classi
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip � Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $