HomeMy WebLinkAboutX2021-3167 - Permit ApplicationPrint Form Worksheet for Combo 8r. (1140
Building Solar Permit ApplicationComm] F_ Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building r Grading Drainage [Elec F_Mech F-plum cuvdcutF
Cu Yd Fill
Project Address (Not mailing address) [ Flood r Fire r- Liq F Landslide [_N/A Floor Suite No
of Work
New/Add SF�— Remodel SFF— Garage/New/Add �—
Use F-7 ConstType
# Stories # Units (if Res)
Valuation$
Material/Labor
OWNER'S NAME
First
Last
Owner's Address � - ----
Owner's E-mail Address
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City State C
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APPLICANT'S NAME Last��
First
Applicant's Address
Applicant's E-mail Address
City - "- State—ZiP F- Tel phor
ARCHITECT/DESIGNER'S NAME Last �,�1 1 First �
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Architect/Designer's Address
City State �— Zir
ENGINEER'S NAME
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Architect/Designer's E-mail Address
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Engineer's Address
City (� C7 V�i� h�lE � State CjJ
Lic. No.�
Engineer's E-mail Address
-
Zip Telephone Tl I lj
CONTRACTOR'S NAME/COMPANY Lic. No.
C, class
Contractor's Address Contractor's E-mail Address
city
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SETBACKS REAR SETBACKS FRONT PERMIT NO. %(t02-1 -jllo'1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2 -S'I 2a
USE ZONE DEVELOPMENT NO PLAN CHECK. FEES $