HomeMy WebLinkAboutXR2023-2288 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application @-)
.r Comm'I r Residential City of Newport Beach - Building Division TE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL a..
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Description of Work
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# Stories # Units (if Res)
Valuation
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OWNER'S NAME Last I bw-c- --T- t r. r
First
Owner's Address
Owners E-mail Address
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City Qlqws b M State
Zip 6pVQ Telephone 4,y'1-343-1:) `I
APPLICANT'S NAME Last
First I L EbC2b1_:
Applicant's Address
Applicant's E-mail Address
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Zip Q1 LI W Telephone qq-i-3q-im 3-1-
ARCHITECT/DESIGNER'S NAME Last First F
Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zip F TelephoneF
ENGINEER'S NAME Last
First F Lic. No.F__
Engineer's Address
Engineer's E-mail Address
City I State F_
Zip I TelephoneF_
CONTRACTOR'S NAME/COMPANY
Lic. No. [-- Class
Contractor's Address
Contractor's E-mail Address
City I State F__
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. >(r UW — ZZn
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. (:2
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $