HomeMy WebLinkAboutX2020-1249 - Permit Application•t.;Pnnf Form Worksheet for Combo Building &Solar Permit Application o
E°°°�_
`ZQ 2 `{ City of Newport Beach - Building Division Z67, b
Comm'I Resi Iqg
ential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL / ,-L, Il Y�
rBuilding r Grading F-Drainage r Elec F_Mech F- Plum CuvdCut F_ CuvdFill F_
Project Address (Not mailing address) f Flood F_ Fire F_ Liq r Landslide FN/A Floor Suite No
r
Description of Work
Use F—ConstType I—
# Stories[— # Units (if Res)F—
Valuation $
Material/Labor
New,iAdd SF j v Remodel SF �— Garage/New/Add �—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State � Zip I Telephone
APPLICANT'S NAME Last
F First
Applicant's Address
Applicant's E-mail Address
City F
State �® Zip F— TelephoneF_
ARCHITECT/DESIGNER'S NAME
Last First F_
Lic. No. F_
Architect/Designer's Address
Architect/Designees E-mail Address
City
State �— Zip F— TelephoneF_
ENGINEER'S NAME Last
First F_ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F_ Telephone[ —
CONTRACTOR'S NAME/COMPANY
�,A DW> Lic. No. r %s VClassR
lid v�
Contractor's Address
Contractor's E-mail Address
City (iQ tom` (^ �� 0,\
State Zip l Telephone 11-\N 7_`%�j-30
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
10