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HomeMy WebLinkAboutX2021-2036 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit AppliSation City of Newport Beach - Building Division X`2 F_ Comm'I r Residential g X (�Q 70310 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F—Building r Grading Address of Work r"Drainage F_Elec F_Mech Plum CuvdCut CuvdFill F mailing address) f— Flood r Fire r Liq r Landslide rN/A Floor Suite No � I 1 Uvi.elo F__ F-- New/Add SFF— Remodel SFF Garage/New/Add OWNER'S NAME Last Owner's Address First Use ConstTypeF # Stories # Units (if Res)F Owner's E-mail Address City State Zip F— Telephoner— APPLICANT'S elephoner APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State F Zip �— Telephone[ ENGINEER'S NAME Last a First Lic. NoT— Engineer's Address Engineer's E-mail Address City State F Zip TelephoneF— CONTRACTOR'S NAME/COMPANY F &621N Lic. No. :T Mass Contractor's Address Contractor's E-mail Address 6',,t Grol ,N��i/,Ca,� CityState � Zip l 2 / Telephone G� C SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 101 W1 Valuation $ Material/Labor Owner's E-mail Address City State Zip F— Telephoner— APPLICANT'S elephoner APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State F Zip �— Telephone[ ENGINEER'S NAME Last a First Lic. NoT— Engineer's Address Engineer's E-mail Address City State F Zip TelephoneF— CONTRACTOR'S NAME/COMPANY F &621N Lic. No. :T Mass Contractor's Address Contractor's E-mail Address 6',,t Grol ,N��i/,Ca,� CityState � Zip l 2 / Telephone G� C SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 101 W1