HomeMy WebLinkAboutXC2023-0302 - Permit ApplicationPrint FormWorksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
[- Comm'I [-Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building [- Grading [—Drainage [- Elec [- Mech [- Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing
address) [- Flood [- Fire [- Liq r Landslide [-N/A Floor Suite No
Description of Work
Use Const Type
# StoriesF # Units (if Res)[ —
New/Add SFF_ Remodel SFF—Garage/New/Add F—
Valuation $
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State F Zip F_ Telephoned —
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City �
—
State F_ Zip F_ TelephoneF
ARCHITECT/DESIGNER'S NAME
Last First Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F—Zip r Telephoned
ENGINEER'S NAME Last
�— First F_ Lic. No.r
Engineer's Address
Engineer's E-mail Address
City
State F— Zip F Telephone[ —
CONTRACTOR'S NAME/COMPANY
l �✓y�C i` ec t J OC_ Lic. No. % Z Class
Contractor's Address
Contraacctor's E-mail Address
-211 �,v (� Ste- J N 1 D
Z Josr)o Cpyn
City JS „ sf�
�1
State ' Zip qZZ%% Telephone f/�
7(/
/
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $