HomeMy WebLinkAboutPV2023-0042 - Permit ApplicationI_ Print Form I Worksheet for Combo Building & Solar Permit Application
r Comm'I j` Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Projectr F_ Address (Not mailing address) [_ Flood Fire Liq F_ Landslide
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)escription of Work
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New/Add SF1__ Remodel SF
OWNER'S NAME Last
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Garage/New/Add F—
4l yC -e /lr`_ First_
Owner's Address
_ Owner's E-mail Address
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City State ,;;4 Zi �--
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At PULANT'S NAME Last
Applicant's Address
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City F , r3
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City F
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Last
State 7C
Cu Yd Fill
F_N/A Floor
Use Const Type
Suite No
# StoriesF_ # Units (if Res)[ —
Valuation $
Material/Labor
First I 775
Applicant's E-mail Address
ZIP O;v r Telephone ;� Z I y/'i' S2 3>
Lic. No. F--
Architect/Designer's E-mail Address
State F Zip Telephone[�
First
ENGINEER'S NAME Last
First Lic. No.F'
Engineer's Address Engineer's E-mail Address
City �® State I—® zip ,
�— Telephoner'
CONTRACTOR'S NAME/COMPANY
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Contractor's E-mail Address
City ` /2 State
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SETBACKS REAR SETBACKS FRONT PERMIT NO. PV7-02 3 � 00( Z
SETBACKS LEFT SETBACKS RIGHT
USE ZONE PLAN CHECK NO. PGZOZ'3 6176
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