HomeMy WebLinkAboutXC2023-0333 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar
Permii `° r
Comm'I r Residential City of Newport Beach - Building Divisi
NOTE: PLAN CHECK FEES DUE AT TIME OF S BMITTAL
F_Building F_ Grading
F—Drainage F Elec j- Mech j Plum CuYdCut CuYdFill F
Project Address (Not mailing address) F_ Flood r- Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use F—Const Type F_
# Stories # Units (if Res)[_
Valuation $
Material/Labor
New/AddSF�u
Remodel SFF— Garage/New/Add
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State Zip [ Telephoned
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
—
State �— Zip F_ TelephoneF
ARCHITECT/DESIGNER'S NAME Last First I� Lic. F—
No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State Zip I Telephone
ENGINEER'S NAME
Last �— First F_ Lic No.F
Engineer's Address
Engineer's E-mail Address
City
State F Zip �— Telephone d—
ONTRACTOR'S NAME/COMPANYr,
Lic No. VID Class
Contractor's Address
Contractor's E-mail Address
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City JI F �% State I L1,11 Zip Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO.� % J
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N O rA,n> py
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES S