HomeMy WebLinkAboutXR2023-3275 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r— Grading rDrainage F_ Elec F Mech r Plum cuYdCut F_ CuYdFill F_
Project Address (Not availing address) F_ Flood F_ Fire F_Liq F_ Landslide F_N/A Floor Suite No
V /' p�oP- F—
Description of Work
Use F—ConstType F_
if StoriesF # Units (if Res)[
Valuation $
Material/Labor
New/Add SFF—Remodel SF Garage/New/Add
OWNER'S NAME Last First
Owners Address Owner's E-mail Address
City F State �— ZipF Telephon Og
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Addres
lags GI �vt �`P�' u r'Dw
City State �� Zip Telephone v ?3,5 SI&
ARCHITECT/DESIGNER'S NAME Last First �� Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City � State �— Zip r— TelephoneF—
ENGINEER'S NAME Last �i First F_ Lic. No.F—
Engineers Address Engineer's E-mail Address
City State Zip Telephone
—F_
2
CONTRACTOR'S NAME/COMPANY^/ Lic. No. q 317� Class
Contractor's Address LWd� �1 &tSs .r¢'r/`cContractor'Is E-mail Address GI
3� � Od�Gty
City
State W Zip Telephone Goy ((qg-3Sri�
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. LOZ30 7. 3011
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $