HomeMy WebLinkAboutX2020-2378 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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[—Drainage (— Elec j— Mech
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Project Address (Not mailing address) F_ F_ Fire f— Liq F_ Landslide I —N/A Floor Suite No
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Description of Work
Use Const Type
# Stories # Units (if Res)[
Valuation $
New/Add SF�
Remodel SF�W Garage/New/Add F_ Material/Labor
OWNER'S NAME
Last I
First � C_ 6��
Owner's Address
Owner's E-mail Address
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City
I IUG�-v br�
State
zip Tele hone
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APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
F_
Architect/Designer's E-mail Address
City
State
Zip Telephone
ENGINEER'S NAME
Last
First Lic. No.�
Engineer's Address
Engineer's E-mail Address
City
State
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F_ Class
Contractor's Address
Contractor's E-mail Address
City
State F
Zip �` Telephonel
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. X 3CO
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $