HomeMy WebLinkAboutXC2023-0309 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application�R>
r Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F_ Building (— Grading
j—Drainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Pill
Project Address (Not mailing address) f Flood r Fire r— Liq r' Landslide F_N/A Floor Suite No
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F_ F—
Description of Work
ConstType
I�
RFUse
PAt-N"O�
# Storiesr— # Units (if Res)r—
Valuation $
Material/Labor F
New/Add SF �— Remodel SF F—
Garage/New/Add �—
OWNER'S NAME
Last 010 L L.(/
First
Owner's Address
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Owner's E-mail Address
City F
State �— Zip F_ Telephoned ---
APPLICANT'S NAME
Last �\
First
Applicant's Address
Applicant's E- it Address
City
State �—
Zip F— Telephoned!
ARCHITECT/DESIGNER'S NAME Last �—First F_
Lic. No. F_
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City
State F_
ZIP �— Telephone[
ENGINEER'S NAME
Last �
First 7— Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State F
Zip F— TelephoneF_
CONTRACTOR'S NAME/COMPANY
Lic. No. F— Class F_
Contractor's Address
Contractor's E-mail Address
City F—
State
Zip �— Telephone
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WOO
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. "' ✓ 42 021M
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.�(f�t�j.j
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $