HomeMy WebLinkAboutPV2023-0093 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r COmm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r—Building r Grading F-Drainage r Elec
r Mech r Plum Cu vd cutr-- Cu vd Fill
Project Address (Not mailing address) r Flood r— Fire r Liq j— Landslide i—N/A Floor Suite No
description of Work
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New/Add SFr_-- Remodel SFr— Garage/New/Add r---
OWNER'S NAME Last y �n
First /
Owner's Address
j���� Owner's E-mail Address
F2q
City fir State lA Zip
,(A`� Telephor
APPLICANT'S NAME Last �/`/Q' FesI-
First I %H�'Y//T
Applicant's Address
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City `//� Mllr „ State F—
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
City
ENGINEER'S NAME Last
Engineer's Address
City
CONTRACTOR'S NAME/COMPANY
Use F_ ConstType F_
# Storiesr— # Units (if Res)r—
Valuation
Material/Labor
- l92 d
V - r -_/
Applicant's E-mail Address
Zip I 12 fiQ,, TelephoneF(%uP) 12-0 r 72-2� „
First I Lic. No. �-
Architect/Designer's E-mail Address
State F_ Zip I Telephone --
First
Engineer's E-mail Address
Lit. No.[--
1-81
z0le 00
State F_ Zip F— Telephoned--
i pi%/ Q Lic No. fJQI(p Class Of0
Contractor's Address
Contractor's E-mail Address
City WQI9VL7_
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State r? -
Zip
�TelephoneF�
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
PERMIT N0. Cr �' 7^�f(.�
.-
USE ZONE
SETBACKS RIGHT
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PLAN CHECK N0. \�J(iJ —<<
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DEVELOPMENT NO
PLAN CHECK FEES $