HomeMy WebLinkAboutXR2023-2980 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o, mew -Re
r Comm'I Residential City of Newport Beach - Building Division �g
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5,,,0„.'
Building rGrading
rDrainage FElec rMech rPlum CuYdCut F CuYdFill
Project Address (Not mailing address) r— Flood r Fire r Liq r Landslide rN/A Floor Suite No
its TNLow
Description of Work
Use , j Const Type
# Storie_sFw—*- # Units (if Res)F—
t� iN
Valuation
New/Add SF�.�
,
Remodel SF� Garage/New/Add �
Mat erial/Laa bor
OWNER'S NAME
LastIll First ~
Owner's Address
Owner's E-mail Address
City
State ZipFlik-R—Telelphone".W.11114
APPLICANT'S NAME
Last '.[j First
IID���''
Applicant's Address
Applicant's E-mail Address
City
State Zip TelephoneF_
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. ligis/r/►
��+V
ArchitectlDesigner's Address
Architect/Designer's E-mail Address
City ' •.' -
State EV Zip 4zW Telephone , Ow1
O
+ `�/
ENGINEER'S NAME
Last First Lic. No.
I
Engineers Address
Engineer's E-mail Address
City
State F— Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F_— Class
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. ot3 • &q
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. •
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $