HomeMy WebLinkAboutXR2023-0442 - Permit ApplicationPrint Form - Worksheet for Combo Building & Solar Permit Application
f' Comm'I (/Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X,40-.N.3_0y1,
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F_ Fire F Liq [—Landslide F_N/A Floor Suite No
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Description of Work
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New/Add SF[� model SF
NBuilding j_ Grading Drainage r Elec Mech
Project Address (Not mailing address) f- Flood
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Garage/New/Add
Use 2�U Const Type
# Stories # Units (if Res)
Valuation $, —
Material/Labor
APPLICANT'S NAME
Last '�%z-(/,4 FirstJA
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Applicant's Address Applicant's E-mail Address
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City State js G
ZiP Telephone
ARCHITECT/DESIGNER'S NAME Last/A i�%z / First Z
,4ND-) J Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State — Zi �-
Telephone
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ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State F ZiP Telephone
SETBACKS REAR
SETBACKS LEFT
i ISF 7nMP
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK N0.