HomeMy WebLinkAboutPV2021-061 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit App ic tio��� IND
r— Comm I r"- Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building F_ Grading
Drainage F_Elec r'Mech F—Plum Cu Yd Cut cuvdFill
Project Address (Not mailing address) F_ Flood r Fire I— Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use F' Const Type
# Stories # Units (if Res)_
Valuation$
New/Add SFr—--.
Remodel SFF— Garage/New/Add L---
Material/Labor
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State — Zip F_ Telephoned
APPLICANT'S NAME
Last,Qp� 0
First ��
Applicant's Address
Applicant's E-mail Address
City
State �— Zip F Telephone-
ARCHITECT/DESIGNER'S NAME Last First
_.. ',. Lic. No. �_—...
Architect/Designer's Address
Architect/Designer's E-mail Address
CityState
Zip Telephone
ENGINEER'S NAME
Last First r-- Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F_. Zip F_ Telephoned—
CONTRACTOR'S NAME/COMPANY '� 1 _i Lic. No. Class
Contractor's Address
J Contractor's E-mail Address
/�A0l_ lk \�tn V M TY- Div r4i&�, e,�?_St q
City 'C � vm f.
State I oT..... Zip Telephone l - (;2q0 0
SETBACKS REAR,
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $