HomeMy WebLinkAboutXR2023-2225 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q4zEW�ar
City of Newport Beach - Building Division
F_ Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c mar"
j-Building i- Grading
rDrainage r Elec r Mech r Plum CuYdCut t cuYdHI t
Project Address (Not mailing address) F Flood ' Fire r Liq F_ Landslide FN/A Floor Suite No
1020 '3ea Lion
F_ �-
Description of Work
Use F—ConstType
# Stories # Units (if Res)F_r
e 6fn i n Wa
Ft�
New/Add SF F_
Remodel SF F— Garage/New/Add I
Valuation $
Material/Labor
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State F Zip F— Telephoned --
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State �— Zip F— Telephoned
ARCHITECT/DESIGNER'S NAME Last First— �—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F_ Zip [ Telephoned
ENGINEER'S NAME
Last First F_ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
—
State F Zip F_ TelephoneF
CONTRACTOR'S NAME/COMPANY Vy - v1 Lic. No. �ass�
t ✓\
Contractor's Address
Contractor's E-mail Address
City
State I Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. X? Zo23- ZZZS
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. PC_ 2, 2 g,- /?SS
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $