HomeMy WebLinkAboutXR2023-0825 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ozW
r— Comm'I F- Residential City of Newport Beach - Building Division a
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood F- Fire F_ Liq r Landslide FN/Alt—Floo—r Suite No
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Description of Work
Use WgsonstType v:iQ
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Stories #Units (if Res)
Valuation $
Material/Labor 0� �O
New/Add SFF__
Remodel SFF/W?5_— Garage/New/Add F_
OWNER'S NAME
Last ._ HZLV—\U1sJpL First � Y
Owner's Address
Owner's E-mail Address
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State Zipg?L owl%,. Telephone C1461 316_ I171
APPLICANT'S NAME
Last I 'DL*, so LA First
Applicant's Address
Applicant's E-mail Address
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ARCH ITECT,DESIGNER'S NAME LastFirst w�Y Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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City lr
State J i Zip— Telephone t'
ENGINEER'S NAME
Last First Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
- State I— Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY Lic No. F Class;
Contractor's Address
Contractors E-mail Address
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City
State Zip F Telephone —
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 7.i1 �✓ -� �%�Oa"✓�
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. fiCif fJ ��fO�
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $