HomeMy WebLinkAboutPV2023-0352 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading
rDrainage F_ Elec r Mech f Plum CuYdCut s CuYdFill s
Project Address (Not mailing address) r— Flood r' Fire r Liq r Landslide FN/A Floor Suite No
Sb \hicrNify
F_
Description f Work
Use s ConstType F_
# Stories # Units (if Res)[—
Valuation $ J O�
Material/Labor [%
New/Add SFs—
Remodel SFF_Garage/New/Add I r
OWNER'S NAME
Last N(l First M
Owner's Address
Owner's E-mail Address
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City I
State F Zip F— Telephone '0W-MR—�3
APPLICANT'S NAME
Last lV First um
Applicant's Address
Applicant's E-mail Address
S U�� aC'l , �(� I S � ID'i0 (, � • C� m
City
State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First F_ �—
Lic. No.
Arch itecUDesigner's Address
Architect/Designer's E-mail Address
City I
State F_ Zip F_ Telephones
ENGINEER'S NAME
Last First 7— Lic. No.s
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY C-,Cs\IZ ��c Lic No. Z ClassK
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Contractor's Address
Contractor's E-mail Address -
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t-4 w2 3-0
City I
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State F_v� Zip i 1i_ioi4 Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. Gt�Z?7 ^ sL
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $