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HomeMy WebLinkAboutXR2023-1050 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application I- Comm'I F Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U uilding r" Grading r-Drainage r Elec i- Mech j- plum Cu vd cuts Cu vd Fill Project Address (Not mailing address) I— Flood r Fire r Liq r Landslide j-N/A Floor Suite No YE1 lrne 'TAew F_ Description of Work W �W��hYIJ.n'l �1�\S Uses Const7ypes # Stories # Units (if Res)s �r New/Add SF CQ Remodel SFs-- Valuation $ Foio/:�o Garage/New/Add�—Material/Labort OWNER'S NAME Last �� First Owner's Address (� Owner's E-mail Address City I NQ. , Ppstc- L©GS�State _ — I e Zip I i 3 to APPLICANT'S NAME Last FE1 Applicant's Address City�ti State ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address City ENGINEER'S NAME Last Engineer's Address City CONTRACTOR'S NAME/COMPANY Contractor's Address State s---- First 011 Applicant's EI-mail Address ZIP qOV 6 % Telephone rho g'5 i s 3 "i First Lic. No. F-- Architect/Designer's E-mail Address Zip F� Telephones -- First I Lic. Engineer's E-mail Address State F Zip F� Telephoned-- Lic No. F_— Classs— Contractor's E-mail Address City I State F— Zip r-- Telephoned-- SETBACKS REAR SETBACKS FRONT PERMIT NO. ,t'r2Z SETBACKSLEFT /dS� SETBACKS RIGHT USE ZONE PLAN CHECK NO, 1e� ZO —� DEVELOPMENT NO PLAN CHECK FEES $