HomeMy WebLinkAboutXR2023-0417 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I building I Grading r-Drainage j—Elec r-Mech (-'Plum CuYdCutF— CuYdFill F_
Project Address (Not mailing adddre�ss)aF Flood Fire F Liq f— Landslide FN/A Floor
Description of Work
Use r Const Type
# StoriesF # Units (if Res)r—
Valuation $
Material/Labor
New/Add SF
�U9 G g New/Add �—
OWNER'S NAME Last First
Owner's Address -
Owner's E-mail Address
City State �— - -
ZAP � Telephone—
._-__-_.._
__.._..--
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— ZiP F Telephoner—
ARCHITECT/DESIGNER'S NAME Last First F_ Lic. F_
No.
Architect/Designees Address Architect/Designees E-mail Address
City State F— Zip F— TelephoneF_
ENGINEER'S NAME Last First Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State F® ZiP �— TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class
Contractor's Address Contractor's E-mail Address
City State �— Zip �— Telephone'®
SETBACKS REAR SETBACKS FRON PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK JNO�UW4
USE ZONE„�,