HomeMy WebLinkAboutXR2023-1167 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4?Po''m
City of Newport Beach -Building Division a?
r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j'%Vilding rGrading
F-Drainage rElec rMech
F_ -. _+
F-Plum CuvdCut F_ CuYdFill
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType
# StoriesF_ # Units (if Res)[—
- -- --
Valuation $
aterial/Labor FC)
New/Add SF Remodel SF _�F __ Garage/New/Add �—
�y 52
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State F_—
Zip F— TelephoneF—
APPLICANT'S NAME
Last �—
First
Applicant's Address
Applicant's E-mail Address
City �—
State r
Zip F Telephone�—
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
ArchitectlDesigners Address
Architect/Designees E-mail Address
City
State F—
Zip Telephone
ENGINEER'S NAME
Last
First �— Lic. No.1—
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F TelephoneF—
CONTRACTOR'S NAME/COMPANY
Lic. No. F-- Class
Contractors Address
Contractor's E-mail Address
City
State �—
Zip Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. /< rl j �777�
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. P'2U2+`— Z00 LJ
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $