HomeMy WebLinkAboutX2021-2910 - Permit ApplicationPrint Form I - Workabeet for Combo Building & Solar Permit ADDlication A
— Comm'I Residential City of Newport Beach - Building Division = _
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 010.+"
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r`Building rGrading rainage F-Elec F-Mech j`Plum Cu Yd Cut[_ Cu Yd Filll
Project Address (Not mailing address) r Flood r Fire r- Liq [_ Landslide r_N/A Floor Suite No
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Description of Work
Use s Const Type
# Stories # Units (if Res)s
New/Add SF f -- Remodel SF Garage/New/Add F
Valuation $
Material/Labor
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State Zip Telephones
APPLICANT'S NAME Last did First
Applicant's Address Applicant's E-mail Address
City ^� �� ,. State/ P v� Telephone
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ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City � State f Zip Telephoner
ENGINEER'S NAME Last First
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Engineer's Address Engineer's E-mail Address ✓/
City State F Zip Telephoned
CONTRACTOR'S NAME/COMPANY i r Lic.No. �� -r,.J�yr;)Class
Contractor's Address Contractor's E-mail Address
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r State Zip :_ Telephone <T , 7
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEF -SETBACKS RIGHT G� PLAN CHECK NO. C I
USE ZONE VELOPMENT NO �) L% PLAN CHECK FEES $