HomeMy WebLinkAboutXR2023-0998 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application QuOpr Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding j- Grading
j-Drainage r Elec r Mech
r Plum CuvdCut F cuYdFill F
Project Address (Not mailing address) r- Flood
r Fire r Liq r Landslide F_N/A Floor Suite No
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Description of Work
Use F ConstType F
DD \ N
C
L
# StoriesF_ # Units (if Res)F_
Valuation $ n _
Material/Labt-
New/Add SFF Remodel SFF— Garage/New/Add F__
OWNER'S NAME
Last i-T I ,� N
I
First VQ
Y'
Owner's Address
Owner's E-mail Address
City I—
State 1
Zip F_ Telephoned
APPLICANT'S NAME
Last C Al)fl EUX
First j 4 L V'A Z JJ
Applicant's Address
Applicant's E-mail Address
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City -
State
Zip i t— Telephone) - �, y
ARCHITECT/DESIGNER'S NAME Last First F— i F_
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F—
Zip [ Telephoned
ENGINEER'S NAME
Last
First 7— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip �— TelephoneF
CONTRACTOR'S NAME/COMPANY N60j tr]Y6 CU v ✓ Lic. No. zls-��O - Class
,7 & rji.71 LLi /, C
Contractor's Address
Contractor's E-mail Address
City FU
State �f)
Zip !3{Telephone G%
V l
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. j JiiJZ 5
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. -Zi.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
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