HomeMy WebLinkAboutXC2023-0153 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit A lication NE�Po�
/ l Comm'I [I Residential City of Newport Beach - Building Division �
NOTE: PLAN CHECK FEES yyyD..���UE AT TIME OF SUBMITTAL
Building Grading [],Drainage ',{�'I Elec [2finech Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) ❑ Flood [) Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
Description of Work
I— t I Use DLG/lConstTvna
N Units (if Res)s�
Valuation $
New/Add SF � Remodel SF I Garage/New/Add �, Matedal/Lahor
OWNER'S NAME Last
Owner's Address '
Owner's E-mail Address
-- ° '014 I I
City j � Stale A p '� p Af%
G zip Tele hone
APPLICANT'S NAME Last s� J /�_ _— I First — ---
Applicant's Address �=1 Applicant's E-mail Address
City _a ��.. _ State C . I Zip Telephone - Z- —
ARCHITECT/DESIGNER'S NAME i%ty� Y
Last �h �17 First i
Architect/Designees Address
City f y1/I a 1Zi lI-- —J State
rM
Lic No. G7�/,Sh
Architect/Designer's E-mail Address
Zip r 11 2 jj J Telephone CPb
ENGINEER'S NAME Las[ — — First F Lic No.LIi
Engineer's Address
I
City State
Engineer's E-mail Address
Zi
--------------
Tele hone P� p F-- I
CONTRACTOR'S NAME/COMPANY PfMIj
Contractor's Address
City �— _ State
Lic. No. �—'l Class
Contractors E-mail Address �9 a —
Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. )(C 2O Z 3 — d1 S 3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
pQ qPC `IO2 5_ OHS
USE ZONE DEVELOPMENT NO 1 1 1 COZ3.0168.
PLAN CHECK FEES $