HomeMy WebLinkAboutXC2023-0326 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application aav
PComm'I FResidential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES ni IF AT TIME OP: ci IRRAITrni
F_ Building FGrading F—Drainage FElec FMech Fplum CuYdCut F_ CuYdFill
Project Address (Not mailing
address) F Flood r Fire F_ Liq Landslide [_N/A Floor Suite No
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C PO F t1
Description of Work
Use ConstType F_
#Stories #Units (if Res)
Valuation $
Material/Labor
T �
New/Atld"5F Remodel SFF Garage/New/Add F—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State F— Zip [ TelephoneF_
APPLICANT'S NAME Last-j
First
F '
Applicant's Address �y
Applicant's E-mail Address
city �
G
State �� Zlp Dj'J� p�O Telephone p� k' tl
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ARCHITECT/DESIGNER'S NAME
Last First F_
Lic. No.
Archi77��Sftate
Architect/Designees E-mail Address
City
�— Zip r— TelephoneF�
ENGINEER'S NAME Last
First �— Lic. Nof
Engineer's Address
Engineer's E-mail Address
City
State �--- Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY
S�G Lic No. N Clas�
Contrraacttor's Address
Contractor's E-mail Address
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City � �(/�/(1 __ State F�Zip / - /o TelephoneF? Q�ck s"
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. — 7C69� )
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $