HomeMy WebLinkAboutXR2023-2161 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
rjComm'I Tkesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V� o?�
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Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor
Suite No
Description of Work W,,&-
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New/Add SFF_ R el SF --1772
OWNER'S NAME Last 7����y�
Owner's Address
City
APPLICANT'S NAME Last �
Applicant's Address
J`�ES%Dxp / 7G N Use vConstType
# Stories # Units (if Res)
Valuation $ / P�
Garage/New/Add �— Material/Labor•
First
Owner's
State F_ZIP [_ Telephone
City 0A G15VA �S [_V N2D State —
ARCHITECT/DESIGNER'S NAME
Last /
Architect/Designer's Address
City ctat
ENGINEER'S NAME Last
Engineer's Address
City
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
First I y
Applicant's E-mail Address
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Zip Telephone
First yv� Lich Zly
Architect/Designer's E-mail Address
Zip I Telephone
First
Engineer's E-mail Address
State 1 Zip Telephone
Lic. No.F—
Lic. No. F— Class
Contractor's E-mail Address
State �— Zip F— TelephoneF_
SETBACKS FRONT PERMIT NO. ZW-VVVr-i• Za��
SETBACKS RIGHT PLAN CHECK NO. P 61*p;2, I ;
DEVELOPMENT NO PLAN CHECK FEES$