HomeMy WebLinkAboutPV2023-0467 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
F Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building r Grading j—Drainage r Elec
r Mech r" Plum cuvdCut F— cuvdFin
,roject Adddrress�s (N,o/�tt mailing address) F_ FF�lood j/—^/Fire j— Liq F_ Lan/d�slide
New/AddSFF— RemodelSFF— Garage/New/Add F—
OWNER'S NAME Last
Owner's Address
City I State F--
APPLICANT'S NAME Last
Applicant's Address
City F State F_
ARCHITECT/DESIGNER'S NAME
Last�—
Architect/Designer's Address
City State �—
ENGINEER'S NAME Last
Engineer's Address
First
Owner's E-mail Address
rN/A Floor j Suite No
/ p F- I
Use ConstType F_
It StoriesF_ # Units (if Res)r—
S
Zip F, Telephoned ---
First
Applicant's E-mail Address
Zip F� Telephonef�
First
Lic. No. F�
Arch itect/Designer's E-mail Address
Zip F� TelephoneF�
First
Engineer's E-mail Address
Lic. No.F�
City I State F_ Zip [, Telephone F�
CONTRACTOR'S NAME/COMPANY
Lic No. Class
Contractor's Address i
Contractor's E-mail Address
, //7
City trip '� ! �lephone 6
V./• CGjs,
State I q
SETBACKS REAR SETBACKS FRONT PERMIT NO. 3
SETBACKS LEFT SETBACKS RIGHT a^ ,t
PLAN CHECK N t/ t/�V,✓
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $