HomeMy WebLinkAboutXR2023-2823 - Permit ApplicationPrint Form Wdrksheet for Combo Building & Solar Permit Application goiau-_
City of Newport Beach - Building Division r Comm'I r Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading
rDrainage (Elec rMech
plum cuvdCut F cuvdFill F
Project Address (Not mauling a-ddres5) r Flood
r Fire r Liq r Landslide rN/A Floor Suite No
Z
*2
F_ l
Description of Work
Use F—ConstType
# StoriesF # Units (if Res)F—
New/Add SFF—
RemodelSF� Garage/New/Add
Valuation $Fq
Material/Labor-f`.
C
OWNER'S NAME
Last
J
First Ad�1.` A V_1`
Owner's Address
Owner's E-mail Address
City
State F_
Zip F— TelephoneF—
APPLICANT'S NAME
Last _..:_ c, �T,
First (C
Applicant's Address ;
L }
`` Applicant's E-mail Address
City
State �—
Zip F— Telephone
ARCHITECT/DESIGNER'S NAME Last
First F_ F
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
Zip Telephoned
ENGINEER'S NAME
Last iti.�
First Lic.No.
Engineer's Address
- MFr
Engineer's E-mail Address
City
State FJ
Zip �` Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. 7 Class i
Contractor's Address
Contractor's E-mail Address
�i
City (�i ��- UT fv, 7v uv ` �cc.`f. t:r State �� -•-�
Zip G` z-L I � Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.x�%�j •�
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES W
I