HomeMy WebLinkAboutX2021-0810 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm'I Residen I/ '�
i NOTECity of Newport Beach - Building Division
: PLAN CHECK FEES DUE E OF SUBMITTAL
FBuilding F_ Grading rDrainage I- Elec F- Mech F— Plum Ca d r1_�'i 4,,c Fill
Project Address/(Not mailing address) F Flood F_ Fire /Liq ( Landslide I—Nd/fiA ohp i+�Lite No
Description of Work
Use Const Type
(
# Stories167 # Units (if Res)F
MO lwto
1'lt 'pace- o
New/Add SF�— Remodel SFF— Garage/New/Ad
Valuation $
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State F Zip F— Telephone[
APPLICANT'S NAME Last
F_ First
Applicant's Address
Applicant's E-mail Address
City FJ
State � Zip F— Telephone)---_
ARCHITECT/DESIGNER'S NAME
Last F First F—
Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City �—
State I— Zip [— Telephone[
ENGINEER'S NAME Las
tr Lic. V
f^
Engineer's Address
Engiail Address
ity �—
State F— Zip Telephoned
CONTRACTOR'S NAMEXOMPANY
L C Lic No. lass
Contractor's Address
Contractor's E-mail Address
J
City
State F Zip [ TelephoneF_A 1 - 0610
SE ACKS REAR \
SETBACKS FRONT PERMIT NO.
SETBA S LE T
SETBACKS RIGHT PLAN CHECK N
USE ZONE
DEVELOPMENT NO _ PLAN CHECK FEES $