HomeMy WebLinkAboutX2022-0131 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit ^ Application QB
r City of Newport Beach - Building Division ./ ��/2 !i' GO I Comm'1 ResidentialNOTE= PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project (Not mauling address) i— Flood r— Fire r— Liq i Landslide FFA Floor Suite No
�Address
Description of Work
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# Stories #Units (if Res)F—
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MaterialLabor (L '
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Remodel SFF Garage/New/Add �—
OWNER`S NAME
Last re ,4, Ee First `I
Owner's Address
Owner's E-mail Address
City I (2�
State Zip Telephone (_ q LJOG
APPLICANTS NAME
Last \ First
Applicant's Address
Applicant's E-mail Address
City I
State [_ Zip r— Telephoned
ARCHITECT/DESIGNER'S NAME Last First ��� Gt C Lic. No.
ArchdectlDesigner's Address
Architect/Designer's E-mail Address
City 1 ---- State ZipP��63 Teiephone �.4� 1 1)
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ENGINEER'S NAME
Lic No.F—
Last � First I _
Engineer's Address,
Engineer's E-mail Address
City �
State Zip Telephone
� I i r l
CONTRACTOR'S NAMEICOMPANY Lic. No. 1 Class F
Contractor's Address
Contractor's E-mail Address
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City
State F Zip F— TelephoneF_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. l(tii7v�✓` �(°✓'
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. Q��✓O �Oi ?�
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
YOU MUST APPLY FOR A PERMIT AT
THE CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
�► WITHIN 48 HOURS ♦'
INVESTIGATIONAL FEES WILL BE CHARGED
FOR WORK STARTED WITHOUT A PERMIT
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 CIVIC CENTER DRIVE, NEWPORT BEACH CA 92660
(Permit Center is located in Bay C)
PHONE: 949 644-3200
,fPFRMIT(S) REQUIRED FOR WORK IN PROGRESS:
,AO"O BUILDING PERMIT
E
i BUILDING VIOLATION OBSERVED
❑ NO ELECTRICAL PERMIT
❑ ELECTRICAL VIOLATION
❑ NO PLUMBING PERMIT
OBSERVED
❑ PLUMBING VIOLATION OBSERVED
❑ NO MECHANICAL PERMIT
❑ CONSTRUCTION VIOLATION
❑ NO POOL PERMIT
OBSERVED
❑ OTHER
❑ NO GRADING PERMIT
STOP WORK ORDER STUB
Address:
Date: t . 4 Z. Time: .,�..`AM j
Inspector: cSa,;�i.',Q.',-l-0 CAS
Scope of Work Requiring a Permit:
Plans Required? (18" x 24" minimum size): E]yE