HomeMy WebLinkAboutPV2023-0131 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'[ (-SoResidential City of Newport Beach - Building Division yn
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ?46 -0131
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Project Address (Not mailing address) C Flood j— Fire F_ Liq (- Landslide CN/A Floor
Description of Work
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New/AddSPF— Remodel SF F_
Garage/New/AddF-
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Suite No
Use ConstTypeF
# StoriesF_ # Units (if Res)
Valuation $
Material/Labor7?CC>
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OWNER'S NAME Last I �q y„ Ap{?
First
Owner's Address Owner's E-mail Address
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City IVC ' ott �J2c�&I State �— - _- -
� Zip._ a. Telephoner�
APPLICANT'S NAME t
Last 0� t t b 2 v First v l
Applicant's Address
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City Q p2c Q State C�
ARCHITECT/DESIGNER'S NAME Last F_
Architect/Designer's Address
City State �-
Applicant's E-mail Address
Zip Telephone �Ih_2o2 5 h2Z
First I Lic. No. F—
Architect/Designer's E-mail Address
Zip �— Telephoner
ENGINEER'S NAME Last I First
Lic No.F—
Engineer's Address Engineer's E-mail Address
city State F— Zip F Telephone —
CONTRACTOR'S NAME/COMPANY �F����t/
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Contractor's Address Contractor's E-mail Address
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City Qyt,�nryp State CA ZiP g2�E5 Telephoneq �_2dZ-6-'l
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.��, 2
PLAN CHECK FEES $