HomeMy WebLinkAboutX2021-1819 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application CAW
f-' Comm'I City of Newport Beach - Building Division
iX Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
-
Building F_ Grading
(-Drainage rElec F_Mech Plum CuYdCut CuYdFill
Project Address (Not mailing address) F_ Flood r Fire r Liq r, Landslide rN/A Floor Suite No
72 Heliotrope
F
Description of Work
Use �', Const Type
' �` Lis
D
# Stori s� # Units (if Res)[—
New/Add SF�
Remod SF Garage/New/Add �,
aluation $
Material/La r
OWNER'S NAME
Last �— First
Owner's Address
Owner's E-mail Address
City
State F_ Zip F— Telephoned
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State ��', Zip F Telephoned...
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
a
City
State Zip Telephone
ENGINEER'S NAME
Last First Lic.No f
Engineer's Address
..+III / `J�✓
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. XZG2A
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. �VI�
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $