HomeMy WebLinkAboutXR2023-0667 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar (Permit Application
City of Newport Beach - Building Division InU173- ow
F Comm] FL- CLQ,
residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading [—Drainage F_ Elec r Mech F_ Plum Cu Yd CutF Cu Yd Fill F
Project Address (Not marilling address) F_ Flood F Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use Const Type
F
AH�1, IA214-2
# Stories[ # Units (if Res)F
Valuation $
Material/La bor
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last% First
Owner's Address Owner's E-mail Address
City�c_ % _ _ State 7_7 Z Telephon
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City I State zip F_ Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Arch itect/Designer's E-mail Address
City State Zip Tele p hone
ENGINEER'S NAME Last First [-/1/7 Lic. No. (
Engineer's Address Engineer's E-mail Address
C&Z
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor's E-ma il Ad) ress
City State Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. zlxZ 7
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 01C
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $