HomeMy WebLinkAboutXR2023-0820 - Permit Application1__ int___..n j Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j-Building Grading Drainage r Elec [ Mech Plum c d
— - uY Cut Cu Yd Fill I
Project Address (Not mailing address) C Flood r- Fire r" Liq [_ Landslide [N/A Floor Suite No
New/Add SF�— Remodel SFF— Garage/New/Add I _
OWNER'S NAME Last l
First
Owner's Address — Owner's E-mail Address
_ Y--- --
City State �— Zip
APPLICANT'S NAME Last In First
Use Q 71VL Const Type �
# Stories # Units (if Res)F—
Valuation $
Material/Labor
Applicant's Address
Applicant's E-mail Address /
City State F — Zip Telephon L
ARCHITECT/DESIGNER'S NAME Last
1777777777 First F7777 Lic. No.---
rc itec esigners Address Architect/Designer's E-mail Address
-- - - ------
City State �— Zip F -Telephone— -
ENGINEER'S NAME Last
Engineer's Address
City F_
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
State
First F77777 Lic. No.F—
Engineer's E-mail Address
ZIP Telephone—
�� Lic No. �— Class
Contractor's E-mail Address
State �— Zip �— TelephoneF�
SETBACKS FRONT
PERMIT NO,
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $