HomeMy WebLinkAboutX2021-3325 - Permit ApplicationPrint Form WOrh1ilskieet for Combo Building & Solar Permit Application na,
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F Comm'I ,� Residential City of Newport Beach - Building Division
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Description of Work
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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 NAME Last
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Applicant's Address
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Architect/Designer's Address
Architect/Designer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address
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SETBACKS REAR
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SETBACKS FRONT , ,�Q-t PERMIT NO.
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SETBACKS RIGHT PLAN CHECK NO. e
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ .G
Print Form I Worksheet for Combo Building & Solar Permit Application
F Comm'I ( Residential City of Newport Beach - Building Division /
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address I
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Description of Work ( t
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OWNER'S NAME Last I
_ (J � ((- �� First
Owner's Address
Owner's E-mail Address
City I State r_
ZIP F� Telephone
APPLICANT'S NAME
First
Applicant's Address
Applicant's E-mail Address
City State F_ ZIP �— Telephoner
Cu Yd Fill
r-N/A Floor
Suite No
Use F—
Const Type F_
# Storiesi
Units (i
Unif Res)
r %
Valuation $
Material/Labor
U S M 1
Last
ARCHITECT/DESIGNER'S NAME
Last First
ArchitecVDesigner's Address
Lic. No. F_
Architect/Designer's E-mail Address
City State �— ZIP F TelephoneF�
ENGINEER'S NAME Last
First
Engineer's Address
Engineer's E-mail Address
City State [_ Zip I Telephone
Lic. No.F—
CONTRACTOR'S NAME/COMPANY
Lic. No. F— ClassF_
Contractor's Address Contractor's E-mail Address
City State �— Zip F_ TelephoneF�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKSLEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $