HomeMy WebLinkAboutX2021-0506 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing` address) ( Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
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# Stories #Units (if Res)s
Valuation $ 00 b
Material/Labor Fz 1
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Remodel SFs Gara e/New/Add �-
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OWNER'S NAME
Last �rwih First
Owners Address
Owner's E-mail Address
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City
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APPLICANT'S NAME
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME r�
Last 1'rav,c�en �� � «6 First F_ Lic. No.
ArchitecdDesigner's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME
Last First v •, No.F
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Engineer's Address
Engineer's E-mail Address
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State c� Zip q�io/ Telephone 7tcl ZIS-_Z$rlu
CONTRACTOR'S NAME/COMPANY Lic. No. F_Class
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Contractor's Address
Contractor's E-mail Address
City I''J c•✓�hr)- 15,m\ State ZW- Zip 9�GG2i Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $