HomeMy WebLinkAboutPV2023-0299 - Permit Application (2)Print Form I Worksheet for Combo Building & Solar Permit Application (S.
Comm'I Residential City of Newport Beach - Building Division C- NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(-Building r- Grading
j-Drainage 1/�Elec F Mech
r- Plum Cu vd Cut Cu Yd Pill F
Project Address (Not mailing address) r- Flood
i— Fire r Liq r— Landslide i—N/A Floor No
AV
1 Mary
r�Suite
I
Descriptioq of Work
Use F_ ConstType
# StoriesF_ # Units (if Res)F—
Valuation $
Material/Labor
New/Add SF F_Remodel SFF— Garage/New/Add Ir
OWNER'SNAME
Last
First
Owner's Address
Owner's E-mail Address
City
State F_
Zip F_ TelephoneF_
APPLICANT'S NAME
Last ��(Ja �� 1
99 ``
First COTf
Applicant's Address
Applicant's E-mail Address
SCE kc'it S a N-)j J) 3r\ . (�)Y)
City
State
Zip F Telephoner�JL � 1 jV
ARCHITECT/DESIGNER'S NAME Last
First —Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City f --
State F—
Zip F Telephoned
ENGINEER'S NAME
Last
First Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip F— TelephoneF—
CONTRACTOR'S NAME/COMPANY
Lic. No. I���L� Class C10
Contractor's Address
Contractor's E-mail Address
or
City 1 n`/ti vuI hjD yc State
Zip Telephone 001 l -) xry'0-�
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $