HomeMy WebLinkAboutPV2023-0397 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application �EWPoR>
r Comm'I Residential City of Newport Beach - Building Division U 4
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c .oa•"
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Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide [_N/A Floor Suite No
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Description of Work
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# Stories o # Units (if Res)F
no 1 t) 4-zVA C 12 7
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New/Add SFF
Remodel SFF— Garage/New/Add
Valuation $
Material/Labor
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OWNER'S NAME
Last ✓(f C C-aNa First
Owner's Address
Owner's E-mail Address
City NCVfT_A-
State 5 Zip t(Z,GGTelephoneF
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City 0/2uo
State G' Zip �Zb6S Telephone , y Ze>Z-5yc�
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
5VC Q,n pU Architect/Designer's E-mail Address
City I
State F Zip TelephoneF—
ENGINEER'S NAME
Last a l2 �n First 7L Lic. No. 5 S*n-z
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Engineer's Address
Engineer's E-mail Address 0313r Ikr
City
State I— Zip I Telephoned
CONTRACTOR'S NAME/COMPANY �� c ` Lic No. 10I T) Class t` u
Contractor's Address
Contractor's E-mail Address
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City 0ylc��1(5 k
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State �.h Zip �jz 6)f Telephone -(lt� -542'Z
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $