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HomeMy WebLinkAboutPV2023-0441 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application (14P F Comm'I r- Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL (-Building F_Grading rDrainage r-Elec rMech rPlum Cu Yd Cut Cu Yd Fill) Project Address (Not mailing address) F_ Flood r Fire r Liq r- Landslide F_N/A Floor Suite No J0(, `i AT F F Description of Work Use F— Const Type oo P✓icu/14- S ar Z,�>t, - kw # StoriesF_ # Units (if Res)F_ \ ) f New/Add SF�— Remodel SFF— Garage/New/Add F— Valuation $ Material/Labor IT19,Z`1c, V OWNER'S NAME Last r F�"lA,(('1.� I First r.C'<r C Owner's Address Owner's E-mail Address City F_— State �— Zip— Telephone '-? F3- `e.7 APPLICANT'S NAME Last C, l I First J �• Applicant's Address Applicant's E-mail Address City State F_ Zip F— Telephonel— ARCHITECT/DESIGNER'S NAME Last �— First Lic. No. �— ArchitecUDesigner's Address Architect/Designer's E-mail Address City State r Zip Telephoned ENGINEER'S NAME Last f CUG� ` First Lic No.1— `,E� Engineer's Address Engineer's E-mailAdd�resss��" /J ;70-7 �C City State F_— Zip I Telephone CONTRACTOR'S NAME/COMPANY Lic. No. G L 4 Class v - C , Contractor's Address Contractor's E-mail Address City I State F— Zip F Telephoner — SETBACKS REAR SETBACKS FRONT PERMIT NO. �V d v� - ©q q SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PI7,7aZ - CCft I PLAN CHECK FEES $