HomeMy WebLinkAboutX2020-1884 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I r- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X 40�O 1� r
F-Building F- Grading F-Drainage IYEIec XMech XPlum CuYdCut F_ CuYdFill F_
Project Address (Not mailing
address) f_ Flood F- Fire Fv Liq r Landslide F_N/A Floor Suite No
Description of W k
Use �onst Type I,'
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# Sttie� # Units (if Res)[_
Valuation /,
Material/Labor�� V C.
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New/Add SF �� Remodel SF �
Garage/New/Add (
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OWNER'S NAME LastF
First
Owner's Address
Owner's E-mail Address
City
State �
Zip Telephoned
APPLICANT'S NAME Last
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First
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Applicant's Address -
Applicant's E-mail Address
(
City ; `
State
Zip 1 �, Telephone t
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Architect/Designees Address
Architect/Designees E-mail Address
City
State F_
Zip I Telephoners
ENGINEER'S NAME Last
j_j - '� / S Y % �; First 19: lr j Lic No.
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Engineer's Address
Engineer's E-mail Adddrreessss
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city
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State
Zi Tele hone
Zip p
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CONTRACTOR'S NAME/COMPANY
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Lic ewe- Class
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Contractor's Address
Contractor's E-mail Address
(City
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State �
Zip �— Telephoner.
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. X ��-'� L' -- � "f� �'
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $