HomeMy WebLinkAboutX2021-0107 - Permit Application (2)Print Form, : Worksheet for Combo Building & Solar Permit Application oF�`s�
F- Comm r Residential XAV,2I.0t d7 City of Newport Beach -Building Division o � i
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c<,.owNs
rBuilding r Grading
rDrainage [Elec F_Mech r Plum Cu rdCut F cuvdFill
Project Address (Not mailing address) r Flood F -Fire C- Liq (- Landslide rN/A( Floor Suite No
7937 Port Trinity
Description of Work
Use�'' Const Type �.
Bio -retention planter, 16 ft x 73 ft. x 3 ft tall within 3' of prop. line in north corner of lot.
# Stories # Units (if Res)F—
Valuation $
New/Add SF�
Remodel SFF Garage/New/Add �_
5000
Material/Labor
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City �.
,. State F Zip I Telephone
APPLICANT'S NAME
Last _..._ _. First... _..
Applicant's Address
Applicant's E-mail Address
City �...
_ State F_ Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First FF_
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
St
,. State F_ Zip F_Telephoned,
ENGINEER'S NAME
Last First F_ Lic. No.F!,
Engineer's Address
Engineer's E-mail Address
City--
State Zip �— Telephoned..
CONTRACTOR'S NAME/COMPANY Lic. No. ( Class
Contractor's Address
Contractor's E-mail Address
City
State I— Zip Telephoned',
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK 40.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $