HomeMy WebLinkAboutP2023-0029 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application RAUX
F Comm'I JX Residential City of Newport Beach - Building Division
NOTF' PI AN CF-IF(`LC ccoc ni io n
I —Building (— Grading
- - - - - Iuvic yr JUOIVII I IAL
f—Drainage f"Elec 7Mech i-X Plum CurdCut F_ CuvdFill F_ `J
Project Address (Not mailing address) f Flood F Fire r Liq F Landslide FN/A Floor Suite No
430 Fernleaf
Description of Work
Use F Const Type l
Natural gas fuel line for firepit
and future bbq
# Stories[ # Units (if Res)F
Valuation
Material/Labor
New/Add SFr --Remodel
SF�� Garage/New/Add ---
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OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State F--
Zip r--- TelephoneF�
APPLICANT'S NAME
Last � First
Applicant's Address
Applicant's E-mail Address
City �—
State F_ Zip [— Telephoner i
ARCHITECT/DESIGNER'S NAME
r-----
Last �� First F Lic.
Arch itecUDesigner's Address
No.
Arch itecUDesigner's E-mail Address
City �—
State �.-.— Zip �— TelephoneF-------
ENGINEER'S NAME
Last First F_ Lic No.F_
Engineer's Address
Engineers E-mail Address
City F`
State �— Zip - TelephoneF—
CONTRACTOR'S NAME/COMPANY 4 / rk � Lic No. /� � / �550ass�
('
Contractor's Address
Contractor's E-mail Address
City F`
State F Zip �` Telephoned --
SETBACKS REAR
SETBACKS FRONT PERMIT NO.,a
SETBACKS LEFT
SETBACKS RIGHT F!.AN CHECK NO. . �_0G -�(�
SE ZONE
DEVELOPMENT NO FLAN CHECK FEES S