HomeMy WebLinkAboutM2011-0045Worksheet for Building Combo hermit Application WY°R@
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City of Newport Beach - Building Department
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1. Project Address (blot mailing address) � o No
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Tenant Name(if Applicable)
# Units (if Residential)
2. Description of Work
.............................._.............._.... .............................'................. . ......... ...... ... .-........ .
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Extg Building SF Demo Building SF ;Add/Reconstruct Bldg SF
......................... .
..................................................
Extg Gar sf F Demo Garage sf F Add/Reconstruct Garage sf
Use
Valuation $
............:
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TOTAL BLDG SF r
Cu Yd Cut
New Add f7, Alter Demo
TOTAL GARAGE SF Cu Yd Fill -Y
..... ...... .
box
# Stories
4. Architect/Designer's Name Last
1 First Lic. No.
............................._......................................._...._.....: L.............................................................:
)Architect/Designer's Address Architect/Designer's E-mail Address
1
City State Zip Telephone`
OFFICE USE ONLY ENERGY P/C FEE $ PERMIT NO.
GRADING P/C FEE $ FIRE P/C FEE $ PLAN CHECK NO. � (')
O ZO I I
Rev 4116109 ELEC/MECH/PLUM P/C FEE $ PLAN CHECK FEE S
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