HomeMy WebLinkAboutX2021-2807 - Permit ApplicationVosl� 290+
Print`Forin Worksheet for Combo Building $ Solar Permit Application
n Comm'I r, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding nGrading rDrainage [Flet rMech F-1 Plum Cu rd cut Cu rd Fin
---- —
Project Address (Not mailing address) ❑ Flood F] Fire F- Liq r!, Landslide FN/A Floor Suite No
----
Description of Work Use Const Type �I
# Stories # Units (if Res)�I
New/AddSFF— Remodel SF
OWNER'S NAME Last
Owner's Address
Garage/New/Add
First
Owner's E-mail Address
i
City State F Zip Telephone
'
valuation $
Material/Labor - -- - J
APPLICANT'S NAME Last
Applicant's Address
-- — - - --- - --- -- -
City State I
First
Applicant's E-mail Address
Zip Telephoned
ARCHITECT/DESIGNER'S NAME Last First, Lic. No.
Architect/Designers Address
City �! State
Architect(Designer's E-mail Address
Zip �� Telephoned
ENGINEER'S NAME Last First F777 Lic. No.F
—
Engineer's Address
_..
City State
Engineer's E-mail Address
Zip—Telephone ✓ �)(N `���
CONTRACTOR'S NAME/COMPANY /, Lic. No. Class!'
Contractor's Address
City State
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
I
Zip i Telephone
F
PERMIT NO.
PLAN CHECK NO. 4,441 U1, I