HomeMy WebLinkAboutXR2023-0737 - Permit ApplicationPrint Form Workssha,at for Combo Building & Solar Permit Application
Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL u
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# StoriesF # Units (if Res)
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Valuation $
New/Add SF Remodel SF Garage/New/Add �— Material/Labor f � 00
OWNER'S NAME Last G/SLR First
Owner's Address Owner's E-mail Address
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I City l State Zip F— Telephone!
APPLICANT'S NAME Last
Applicant's Address
Address
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ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
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First
Applicant's E-mail Address
Zip gylj 3 Telephone-7
First Lic. No. F--
ArchitecUDesigner's E-mail Address
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Zip �— Telephone ----
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ENGINEER'S NAME Last �� First y o9 (� Lic. No. - -72-
Engineer's Address
Engineers E-mail Address
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City
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State
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Zip
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Telephone
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CONTRACTORS NAMEXOMPANY 5 ) Lic. No. Classl-
Contractors Address Contractors E-mail Address
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SETBACKS REAR
SETBACKS LEFT
USE ZONE
PERMIT NO. X 7- -3 — 6 737
PLAN CHECK NO.
DEVELOPMENT NO &Z g S - C)IUb PLAN CHECK FEES $
SETBACKS FRONT
SETBACKS RIGHT