HomeMy WebLinkAboutX2021-2280 - Permit Application:PnFt{:Form'; '`• 'Worksheet for'Combo Building & Solar Permit Application
F Comm'IResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address);Flood ❑ Fire r Liq
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Suite No
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OWNER'S NAME Last
First
Use Const Type F
# Storiesr— # Units (if Res)1_
Valuation $
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Owner's Address Owner's E-mail Address
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City
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APPLICANT'S NAME Last I /V/(
Applicant's Address
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Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last
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ENGINEER'S NAMELast �— First �— Lic. No �—
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Engineer's Address
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City (� State
Engineer's E-mail Address / J
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CONTRACTOR'S NAME/COMPANY
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Lic. No. 'C-- F7M�w' Class - -
Contractor's Address / Contractor's E-mail Address /
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SETBACKS REAR SETBACKS FRONT, PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK O.
USE ZONE _ _. -:.
DEVELOPMENT NO ES $,
- - --• - PLAN CHECK FEES
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