HomeMy WebLinkAboutXC2024-0285 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j—Building r Grading
F Drainage i- Elec r Mech
r Plum CuvdCut F CuvdFill F
Project Address (Not
mailing address) r— Flood
r Fire j— Liq r Landslide rN/A Floor Suite No
6_�
I I
Description of Work
Use F—Const Type F_
# StoriesF # Units (if Res)_
Valuation
New/Add SFF
Remodel SFF— Garage/New/Add F_—
$
Material/Labor
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State
Zip F TelephoneF
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State �—
Zip F TelephoneF
ARCHITECT/DESIGNER'S NAME Last
First F_
Lic. No.F_
Address
Architect/Designer's E-mail Address
City F__
State F_
Zip F— Telephoned
ENGINEER'S NAME
Last
First F Lic. No f
Engineer's Address
Engineer's E-mail Address
City
State
Zip F Telephone�—
CONTRACTOR'S NAME/COMPANY Lic. No. 6 u Class ) j
Contractor's Address
Contractor's E-mail Address
City
State
Zip ' i2 G 77Telephone '. r 'n i
/
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $