HomeMy WebLinkAboutX2021-2094 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oF.`ro a
F- Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building (- Grading
rDrainage F_ Elec F_Mech
r Plum CuvdCut F CuYdFill �
Project Address (Not mailing address) I- Flood
(- Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use F—ConstType
Tim
# Stories #Units (if Res)
Valuation $
New/Add SF F—
Remodel SF Garage/New/Add F__
Material/Labor
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State F_
Zip F TelephoneF__
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City �
State r_
Zip � Telephoned
ARCHITECT/DESIGNER'S NAME Last First F__ F_Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
Zip F Telephoned
ENGINEER'S NAME
Last
FirstI Lic. No.F
Engineer's Address
Engineer's E-mail Address
City I—
State F__
Zip F_ Telephone[ —
CONTRACTOR'S NAME/COMPANY V l _ / .
Lic No. -112 Class
Contractor's Address
Contractor's E-mail Address
City I—
State F__
Zip F Telephoned
�21 Z
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. I� 1ZdZ
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $