HomeMy WebLinkAboutH2022-0531 - Permit Application0 Print Form Worksheet for Combo Building & Solar Permit Application oF,` U`°aa
j—i Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading
rDrainage r Elec r—j Mech F Plum Cu Yd Cut Cu Yd FIII
Project Address (Not mailing address) r Flood r— Fire r Liq r— Landslide rN/A Floor Suite No
12 Heliotrope
I I
Description of Work
Use �', ConstType F
# Stories # Units (if Res)[ —
Valuation $
Material/Labor
New/Add SFr— Remodel SFF
Garage/New/Add F__I
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City �
State Zip F— Telephoned
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F
Zip F Telephoner- ...
ARCHITECT/DESIGNER'S NAME Last First 7— r
Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip Telephoner;
ENGINEER'S NAME
Last
'First F_', Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City r
State I
Zip I Telephone
CONTRACTOR'S NAME/COMPANY
Lic No. F Class
Contractor's Address
Contractor's E-mail Address
City
State
Zip F Telephoner
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. E-12,GZ.Z-Q�31
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $