HomeMy WebLinkAboutPV2023-0440 - Permit ApplicationL Print Form_ Worksheet for Combo Building & Solar Permit Application O4 �fW Oy6
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building j- Grading rDrainage rElec [_Mech r Plum cuYdCut CuYdFill s
Project Address (Not mailing
address) F_ Flood r Fire r Liq r Landslide (-N/A Floor Suite No
PT. A CC r �-
Description of Work
Use Const Type F
F r, L-` °;
# Stories #Units (if Res)
_
(ii) Ac moa,nieS 9
2)c-, k0ii, iC!°. ] k;•1n
1
New/AddSFF Remodel SFF—Garage/New/Add
Valuation$ ,tZ,C 5,)Nr'
Material/Labor
15 -
OWNER'S NAME Last
ri;�,re-V�v0,First
Owner's Address
Owner's E-mail Address
City
State Zip Telephone 7�- 3°'
APPLICANT'S NAME Last
Col l i h j First J o J�
l
Applicant's Address
Applicant's E-mail Address
City I
State Zip Fi Telephoned-
ARCHITECT/DESIGNER'S NAME
Last First— F
Lic No.F_
Address
Architect/Designees E-mail Address
City
State Zip F_ TelephoneF_
ENGINEER'S NAME Last
First �— Lic. No.F-
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F— TelephoneF—
CONTRACTOR'S NAME/COMPANY
`, r, r Lic No. F Class - D
Contractors Address
Contractor's E-mail Address
City I—
State F_ Zip F_ Telephones
SETBACKS REAR
SETBACKS FRONT PERMIT NO. \-V Z0Z/� --b4 q C>
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
n �r
DEVELOPMENT NO F n bkVq PLAN CHECK FEES $