HomeMy WebLinkAboutX2020-0686 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application o�EW�Re
Comm'I Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding r Grading
F-Drainage F_ F Mech
F Plum CuvdCut CuYdFill F_
Project Address (Not mailing address) I- Flood
r Fire F_ Liq r Landslide r_N/A Floor Suite No
escription of Work
Use F—ConstType F_
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# Stories # Units (if Res)F
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Valuatio/A
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New/Add SF F_ Remodel SF F—Garage/New/Add F_
Material/Labor
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State �
Zip [_ Telephoned
APPLICANT'S NAME
Last
First
Applicant's Address -
Applicant's E-mail Address
!..; ./.
-A v
City '.,. /
-, / State c'"
Zip ��..�� ✓•:c'- Telephone `• ;`%�% t..'.
ARCHITECT/DESIGNER'S NAME Last First.F_ Lic. No. �
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �
Zip F_ Telephoned
ENGINEER'S NAME
Last
First Lic. No.[
Engineer's Address
Engineer's E-mail Address
City
State F
Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY
Lic. No. Class[ —
Contractors Address
Contractor's E-mail Address
City �—
State F—
Zip F— Telephoned
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. co
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $