HomeMy WebLinkAboutH2022-0095 - Permit ApplicationPrint Farm Worksheet for Combo Building & Solar Permit Application 4��°�a>
— --
r Comm'I F_ Residential City of Newport Beach - Building Division 1r}�
NOTE: PLAN CHECK FEES DUE AT TIMF OF RI IRlull
F-Building F_ Grading
Drainage F_ Elec F_ Mech j Plum Cu vd cut Cu Yd Fill F_
Project Address (Not mailing address) F Flood F_ Fire r Liq f Landslide I —N/A Floor Suite No
Description of Work
Use Const Type
# StoriesF # Units (if Res)F
Valuation $
Material/Labor
New/Add SFF -- Remodel SF( Garage/New/Add —
OWNER'SNAME
Last
First
Owner's Address
Owners E-mail Address
City
State �-
Zip [_ Telephoned --
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F_
Zip [-Telephone F_
ARCHITECT/DESIGNER'S NAME Last
First F_ Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �
Zip � Telephoned --
ENGINEER'S NAME
Last
First F Lic. No.�—
Engineer's Address
Engineer's E-mail Address
City
State
Zip F_ Telephone �—
CONTRACTOR'S NAME/COMPANY
Lic. No. Class ---
Contractor's Address
Contractor's E-mail Address
City
State F_
Zip Telephone F_
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEE"