HomeMy WebLinkAboutXR2023-0261 - Permit ApplicationWorksheet for Building :Combo Permit Application
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address)
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OWNER'S NAME Last
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Owner's Address —� —
Owner's E-mail Address
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Applicant's Address
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LIVU11YEER'S NAME Last I ill- P6
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City R State
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City State
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GRADING P/C FEE $
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Comm'I [ Residential
First
CU Yd Fill
Floor Suite Nc
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# StoriesF9 # Units (if Res)
Valuation $
Material/Labor 010
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Applic nt's E-mail Address
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First
Lic. No. r--
Architect/Designer's E-mail Address
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Engineer's E-mail Address
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Contractors E-mail Address
Lic. No. �3i 44t7 Class
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13 AN CHECK NO.
ELEC/PLUM/MECH P/C FEE $
DEVELOPMENT
PLAN CHECK FEE $
#
TOTAL FEES PAID $
FIRE P/C FEE $
PLANNING P/C FEE $
PC2oZ2)-0199