HomeMy WebLinkAboutX2017-3938 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F- Comm'I r Residential
NOTE:
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F_ Grading
j—Drainage f—Elec F_Mech
F_ Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) [ Flood
F- Fire r Liq F_ Landslide CN/A Floor Suite No
Description of Work
Use I ConstType F_—
# StoriesF if Res)F—
V uatio
New/Add SF
Remodel SF7— Garage/New/Add
aterial/L or
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
_ State �—
Zip F TelephoneF
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State �—
Zip Telephoned—
ARCHITECT/DESIGNER'S NAME Last
First �— Lic. No. �-
ArchitecttDesigner's Address
ArchitectlDesigner's E-mail Address
City {
State i
Zip F_ TelephoneF—
ENGINEER'S NAME
Last
First F_Lic.No.F
Engineer's Addret:s
Engineer's E-mail Address
City
State
Zip Telephonels
CONTRACTOR'S NAME/COMPANY
Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City ---.�
Y State
Zip Telephone)
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $