HomeMy WebLinkAboutXR2023-0546 - Permit ApplicationI Pnnf Form Worksheet for Combo Building & Solar Permit AppllcatIon
Comm'I [ Residential City of Newport Beach - Building Division ,roo NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �•
r-Building [ Grading F-Drainage F_ Elec F_ Mech
j"- Plum Cu Yd Cut F Cu Yd Fill F
Project Address (Plot mailing address) F_Flood
F_ Fire F— Liq F_Landslide [N/A Floor Suite No
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elm "'V�- - -
- - --
Description of Work
Use F_ Const Type
# Storiesrs # Units (if Res)r—
416
1
Valuation $
New/Add SFr----- Remodel SFr-- Garage/New/Addy—
Material/Labor-
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
CityState �—
i
Zip r— Telephoner— --
- -- -
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
city F-- State F
Zip TelephoneF—
ARCHITECT/DESIGNER'S NAME Last First I - Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip �— Telephoned
ENGINEER'S NAME Last
First Lic. Not
Engineer's Address
Engineers E-mail Address
City State
Zip Telephone[—
CONTRACTOR'S NAME/COMPANY I �f Fsy/�1
��i
Lic No. Class
s0C 1 .
Contractor's Address
Contractor's E-mail Address
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City /l c,Y2/I�CZ �lS%YllLc _ State C,�
Zip ��%S Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. W �0� �I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
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