HomeMy WebLinkAboutX2021-0303 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application z E >a
CortiResidential I ty of Newport Beach - Building sion
NOTE: PLAN CHECK FEES DUE X%�%,-,- U10J '
Building [_Grading rDrainage f-Elec F_Mech F-Plum Cu Yd Cut F_Cu Yd Fill
Project Address (Not mailing address) f Flood ( Fire r_ Liq F- Landslide I -N/A Floor Suite No
Description i Work
Use F—ConstTypeF
# StoriesF_ # Units (if Res)[ —
New/AddSFF— Remodel SF Garage/New/AddF
Valuation $
Material/Labor
OWNER'S NAME Last *"aillres
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Owner's Address ' w
F TA I
City State F_ Zip — Telephoned
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State F_ Zip Telephone)
ARCHITECT/DESIGNER'S NAME Last First I Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_ Zip I TelephoneF_
ENGINEER'S NAME Last �-- First F— Lic. No.F
Engineer's Address Engineer's E-mail Address
City � State [_ Zip Telephone[ —
CONTRACTOR'S NAME/COMPANY C �ti Cc ^�C,��r(i j Lic No. Class j
Contractor's Address Con radoCs E-mail Address
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City I (cc, State (T Zip (4—),(, % Telephone 11_ {P5�"
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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