HomeMy WebLinkAboutPV2023-0114 - Permit ApplicationPrint Form /I Worksheet for Combo Building & Solar Permit Application
F Comm I F✓ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V
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F-Building Grading F-Drainage F_ Elec Mech F Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ Flood F_ Fire F- Liq F_ Landslide FN/A Floor Suite No
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Description of Work
Use ConstType
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# Stories # Units (if Res)s
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Valuation $
Material/Labor
New/Add SF F_Remodel SFF Garage/New/Add 7—
OWNER'S NAME Last �an� t First FR44(n
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Owner's Address Owner's E-mail Address
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City 'VeW-,'I h� /tiLI State C/ Zip �G66 Telephone
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APPLICANT'S NAME Last S First Sco+�
Applicant's Address Applicant's E-mail Address
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City O n C le toeA P State CA Zip CLA6 Z 3 Te;ephoneF9qq
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_ Zip �— Telephoner
ENGINEER'S NAME y Last T.PUjC)n t First P��/1� Lic.No.C7V'7P)
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Engineer's Address Engineer's E-mail Address
City State I 6A Zip F— Telephone[ —
CONTRACTOR'S NAME/COMPANY EAI 5k4e tej `241ar Lic No. (v e i 61 � Class c ti c
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Contractor's Address Contractors E-mail Address
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City �� C1UAPA+e State F- Zip F 1A673 Telephone qqq-qi7-Rqw
SETBACKS REAR SETBACKS FRONT PERMIT NO. Ades . D`/v
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $