HomeMy WebLinkAboutX2019-0787 - Permit ApplicationPrint Form 1
F-Comm'I —(7
Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division X10I t4'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building I_ Grading
F—Drainage j_ Elec j— Mech F- Plum
Cu Yd Cut F_Cu Yd Fill [_
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq
r" Landslide I_N/A Floor Suite No
F
F_
Description of Work
Use Const Type
1
# Stories #Units (if Res)
Valuation
Material/Labor
% �
New/Add SF Remodel SF �arage/New/Add
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City F
State f _- Zip
TelephoneF_-�_ -_'���
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City f _ W
State �� Zip
Telephoned _
ARCHITECT/DESIGNER'S NAME Last V First
F Lic. No.
Architect/Designer's Address
Architect/Designer's
E-mail Address
City
State F Zip
Telephone[
ENGINEER'S NAME
Last
Engineer's Address
Engineer's E-mail Address
C
City
State Zip
Telephonek
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City
F_
State F Zip
Telephoned
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.YU69
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $