HomeMy WebLinkAboutPV2023-0024 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar PermA lication ���WPORT
Residential r- City of Newport Beach - Building DivisionVU
j-Comm] -��
NOTE: PLAN CHECK FEES DUE AT TIME OF
SUBMITTAL
[—Building Grading Drainage r Elec Mech Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) f- Flood f— Fire F_ Liq F_ Landslide f-N/A Floor Suite No
. .. ....... . ..... . ... ...... ...
Description of Work Use F—Const Type
1�04 YlouIn �e� ��c,jrtitr �U Lv,��1 I o�����n .�,. � l��
10011A I� 5 \ iJ (; ��i Col1/1F�i Ul�r �av�� #Stories #Units (if Res)
_ n n air
New/Add SF Remodel SF Garage/New/Add �® Valuation $Material/Labor LS �fl(j
OWNER'S NAME Last i ��.� First
Owner's Address Owner's E-mail Address
3{- �J a -
City N 2 W jio C� B cac(n State
Zip .._� v2(,� Telephone —
APPLICANT'S NAME Last 15 First
Applicant's Address Applicant's E-mail Address
City State -Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First
Lic. No.
Arch itect/Designer's Address Architect/Designer's E-mail Address
-- --
City _ State �— Zip I— Telephone -_
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State F Zip Telephone
CONTRACTOR'S NAME/COMPANY Sc>��iV Lic. No. cios Class ch 1,0
Contractor's Address Contractor's E-mail Address
City State Zip Telephone
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT PERMIT NO. C Y ZC 5Z,5 ~-- /V)Z -j
SETBACKS RIGHT PLAN CHECK NO. 9(1141 d 6 — oI U7
DEVELOPMENT NO Q7�i1 — p Z+% PLAN CHECK FEES $