HomeMy WebLinkAboutX2021-1044 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
f— Residential City of Newport Beach - Building Division 04�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
_,Building Grading f—Drainage r—Elec rMech [—Plum Cu yd cute Cu rd Fin
Project Address (NOt mailing address) r—, Flood rr Firer" Liq r; LandslideN/A Floor Suite No
Description of Work
Use Const Type
# Stories # Units (if Res
)s
New/Add SF Remodel Remodel SF Garage/New/Add �— Valuation $
Material/Labor
OWNER'S NAME
Last {''_� First
Owner's Address
Owner's E-mail Address
City j State Zip �% Z e Telephoned
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
— -.
cityF State F ZiP F— Telephoner
ARCHITECT/DESIGNER'S NAME j'��..
Last .__ i C FirstVic, �Tct y_ Lic. No. I
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_ Zip Telephoned
ENGINEER'S NAME Last F First Lic. No.
Engineer's Address Engineer's E-mail Address
City �— State �— Zip �— Telephone
CONTRACTOR'S NAME/COMPANY�' E PC
!. I.
Lic. No. j . , / e 1 lass
t CVC c3 /`r .r.
Contractor's Address /
Contractor's E-mail Address
City Zi
-. - �t GF r State P G 1 7 Telephone f/
>.
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $