HomeMy WebLinkAboutX2021-1483 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application naw
Comm'I Cit of New ort Beach - Buildin Division
Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Ivl uilding r- Grading rpurainage j` Elec F Mech F- Plum CuvdCut F_ cuvdFill
Project Address (Not mailing address) F Flood r- Fire F_ Liq F Landslide r_N/A Floor Suite No
Description of Work
Use ConstType�
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#Stories #Units (if Res)
Valuation a
Material/Labor
New/Add SF /� 5ch o Remodel SF �i
Garage/New/Add �—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City �- State F—
Zip f�` Telephone yC� l)6
APPLICANT'S NAME Last ,��c�qs
First l z�zz2�
Applicant's Address
Applicant's E-mail Address
City �j�'r,',
�;
-r- - State
Zip G���� Telephone %
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ARCHITECT/DESIGNER'S NAME Last �� c�q
First„ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F- State F_
Zip [_ Telephone[ —
ENGINEER'S NAME Last
First F_ �-
Lic. No.
Engineer's Address
Engineer's E-mail Address
City State ��
Zip �s Telephoned`
CONTRACTOR'S NAME/COMPANY
Cr C7/Z��-
/ �J (7 Class G.
illli&rI?7 117161 tic. No. L7
Contractor's Address
Contractor's E-mail Address
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City (�/'�'/+✓1 State 7�
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Zip C�� _
P G��7 Telephone C7W
SETBACKS REAR `7 SETBACKS FRONT
L !' J ��/..,
�> PERMIT NO. � ,\ / L
SETBACKS LEFT `j SETBACKS RIGHT
PLAN CHECK NO. Z-1 % - ZEi LI
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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