HomeMy WebLinkAboutX2022-1013 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Comm'I j Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_ Grading
)—Drainage F_ Elec f— Mech
F Plum Cu vd Cut Cu Vd Fill
Project Address (Not mailing address) F Flood
F_ Fire F_ Liq j— Landslide F_N/A Floor Suite No
Description of Work
Use F_ ConstType I—
� �t
v v
# StoriesF # Units (if Res)F—
Valuation $
Material/Labor CrII
New/Add SF Remodel SF Garage/New/Add
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 F_
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designees Address
Architect/Designees E-mail Address
City
State r
Zip F_ TelephoneF_
ENGINEER'S NAME
Last
First Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F-- ClassF
Contractor's Address
Contractor's E-mail Address
City
State F_
Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. XZOZZ—) 3
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. 2
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $