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HomeMy WebLinkAboutPV2023-0390 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (N-P --- - -1 9r Comm'I r Residential City of Newport Beach -Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL j-Building r'Grading F-Drainage j-Elec rMech j-Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) r Flood r Fire r Liq r Landslide FN/A Floor Suite No 3U9 (,�oi�eofoA kie r Description of Work Use Const Type Roo P�OIA^ SOjac S 150 kw . #Stories #Units (if Res) 111) �c= ()) F,5t' � AC- 1VP 1(5&ov,I,, `� New/Add SFF_ RemodelSFF— Garage/New/Add Valuation $ Material/Labor F,/, to © o OWNER'S NAME Last I C,,kCv,, First Owner's Address Owner's E-mail Address 3 01j Grp { A 6 V, t o N Aj e. i i nrn c oh e� I d o,a1 • �o r City rJew }or � ze(A6-. State L p- Zip [— Telephone q'j 9 - 911 j - ( J 10 APPLICANT'S NAME Last J p First Lo{ i n j Applicant's Address Applicant's E-mail Address City I State I Zip F_ Telephoned ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Arch itect/Designer's E-mail Address City I State F_ Zip F— Telephoned ENGINEER'S NAME Last p -LAC ) u(1%lr P�C�h i First Lic No.FC 7c I % iS Engineers Address Engineer's E-mail Address City State Zip �— Telephone F CONTRACTOR'S NAME/COMPANY _ I Lic. No. ��� y �' S Class 'I0 5 d qv Contractor's Address Contractors E-mail Address City I State F_ Zip F_ Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO. ?yl� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. PcZ(JLa - C40 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $