HomeMy WebLinkAboutX2021-2871 - Permit Application1 Print Form _I Worksheet for Combo Building & Solar Permit Application 001.6
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City of Newport Beach - Building Division
( Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building F_Grading F=Drainage F_Elec r7Mech rPlum CuYdCut F CuvdFill F
Project Address (Notmailing address) F_ Flood r Fire F— Liq F_ Landslide i-N/A Floor Suite No
Description of Work
Use F_ Const Type
y.
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# StoriesF_ # Units (if Res)F—
Valuation $ ��—
Material/Labor) �Jv/
New/Add SF Remodel SF�— Garage/New/Add
OWNER'S NAME Last
�(A First
Owner's Address
Owner's E-mail Address
City State Zip F — Telephon
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City
State �— ZipF TelephoneF—
ARCHITECT/DESIGNER'S NAME
Last First �— F—
Lic. No.
ArchitecUDesiner's Address
9
Architect/Designer's E-mail Address
City
State Zip F Telephoner
ENGINEER'S NAME Last
First F® Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F Zip Telephone
CONTRACTOR'S NAME/COMPANY
O Lic No. �— Class
Contractor's Address
Contractor's E-mail Address
City
State �— Zip Telephoned®
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $