HomeMy WebLinkAboutX2022-1198 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application
Comm'I'. Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding Grading
[—Drainage F_ Elec Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F Fire F_ Liq F Landslide F_N/A Floor Suite No
Vr
Description of Work
Use Const Type
# Stories # Units (if Res)
AND gAt tom
New/Add SF
Remodel SF g
Gara a/New/Add
Valuation $
Material/Labor
OWNER'S NAME
Last r�Y - First
Owner's Address
Owner's E-mail Address
City
State Zip r� Telephoned
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First I Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip F� Telephoned
ENGINEER'S NAME
Last First F Lic. No.l—
Engineer's Address
Engineer's E-mail Address
City--
State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. �pt,la 364 Class
Contractor's Address
Contractor's E-mail Address
Q
City I rc,,, cy, Qe<Y_
State Zip °trr'�- Telephone L���I
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $