HomeMy WebLinkAboutX2021-1328 - Permit ApplicationOSH9721_�<
Print Form Worksheet for Combo Building & Solar Permit Application o��EWPOR�
�` City of Newport Beach - Building Division
Comm" Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading F`Drainage F_ Elec F_ Mech Plum CuYdCut F CuYdFill
Project Address (Not mailing
address) F_ Flood Fire F_ Liq Landslide XN/A Floor Suite No
OJT_/
Description of Work
Use F Const Type F
toriesr— # Units (if Res)[_
-_J i 1
`� �C--
y /
Valuation
New/Add SF Remodel SF Garage/New/Add ��
Material/Laa bor
OWNER'S NAME Last F
First
Owner's Address
Owner's E-mail Address
City F
State F Zip F Telephoned
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City
State Zip Telephoned
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Architect/Designer's Address
F
Architect/Designer's E-mail Address
F_
City
State F Zip �� Telephone
ENGINEER'S NAME Last
� First ILic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City
State Zip Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $