HomeMy WebLinkAboutX2021-3110 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r City of Newport Beach - Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building F_ Grading F—Drainage r Elec F_ Mech F` Plum Cu vd Cut Cu vd Fill F
Pxolect Address (Not mailing address) f Flood r" Fire F_ Liq F_ Landslide F_N/A Floor
Description of Work
Suite No
F_
Use F— Const Type �--
# StoriesF_ # Units (if Res)
(` Valuation $
New/Add SF Remodel SF Garage/New/Add I Material/Labor
ER'S NAME Last First
Owner's Address Owner's E-mail Address
OA
kv
F
ity State I'' Zip Telephone
_ _
PLICANT'S NAME
Last First
icant's Address
ITECT/DESIGNER'S NAME
is Address
Applicant's E-mail Address
State F Zip Telephone
Last First Lic. No.
Architect/Designer's E-mail Address
State Zip Telephone
ER'S NAME Last First Lic. No.F
i
is Address Engineer's E-mail Address
State Zip Telephone
S NAME/COMPANY
Address
Lic. No. Class
Contractor's E-mail Address
State F Zip Telephone
EAR `®
SETBACKS FRONT
`�
PERMIT NO.
�FT
SETBACKS RIGHT
PLAN CHECK NO.
L:
DEVELOPMENT NO
PLAN CHECK FEES $