HomeMy WebLinkAboutPV2023-0159 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application cEsPoq>
[- Comm" residential City of Newport Beach -Building Division �
/ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL oa.
Building [Grading [—Drainage [-Elec [-Mech F-'Plum cuydcut cuvdFill r
Project Address (Not mailing address) F_Flood F_Fire [- Liq [- Landslide [-N/A Floor Suite No
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Description of Work
Use F Const Type
041 Xdl
# Stories # Units (if Res)[ —
Valuation $
Material/Labor
New Add SF C j Remodel SF F_Garage/New/Add F_
OWNER'S NAME Last s j % First p
Owner's Address Owner's E-mail Address
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City /V� t/ 6y State F Zip I ' �Y3 Telephone ?(, 64,Z_yb OUD
APPLICANT'S NAME Last ��/�� First
Applicant's Address Applicant's E-mail Address
City State Zip Telephonel—
ARCHITECT/DESIGNER'S NAME Last First �-
Lic No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_ Zip F_ Telephoned
ENGINEER'S NAME Last First Lic. No.
Engineers Address Engineer's E-mail Address
City State Zip F_ TelephoneF
CONTRACTOR'S NAME/COMPANY Lic No. j,�(� yL1 Class C_
Contractors Address Contractor's E-mail Address
city (.{/,5—_%v xC�/, ° State Zip Telephone 1 � % /v l r✓9
SETBACKS REAR SETBACKS FRONT PERMIT NO. / Z 3 _ &S-
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. lt�_
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $