HomeMy WebLinkAboutPV2023-0121 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm I residential City of Newport Beach - Building Division ^1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL"
rBuilding F_ Grading [-Drainage rElec rMech F- plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ F- Firer Liq F_ Landslide FN/A Floor Suite No
Description of Work
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# Stories #Units (if Res)
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Valuation$ Z OVV
Material/Labor
New/Add SF y, /-A Remodel SF ,,h Garage/New/Add �/��
OWNER'S NAME Last C' ck First a
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Owner's Address Owner's E-mail Address
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City ✓ ) -` ` State - A Zip L L6 f Telephone 7J y `i - L/ 2Z
APPLICANT'S NAME Last C � y- iS 4,,� /L J First
Applicant's Address Applicant's E-mail Address
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City State �— Zip F Telephoner
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip [ Telephoner
ENGINEER'S NAME Last FirstF_Lic. No.F_
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY CJ rI5 a 3 �un ),Lic. No. �I 0 --;LV lass7
Contractor's Address Contractor's E-mail Address
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City ( �S Gti�S6� State Zip �/C t � Telephone `� /Ct/ 3 �2 - I COC�
SETBACKS REAR TBACKS FRONT PERMIT NO. { VZO13` 01
SETBACKS LEFT ETBACKS RIGHT PLAN CHECK NO, FMI-$-04 S
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USE ZONE DEVELOPMENT NO pZ621 -01 6O PLAN CHECK FEES $