HomeMy WebLinkAboutM2024-0063 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division
F_ Comm]r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL(FO
F-Building r Grading F-Drainage r Elec r Mech j- Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) r Flood r Fire r Liq F_ Landslide rN/A Floor Suite No
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Description of Work
Use F—ConstType F_
# StoriesF_ # Units (if Res)F_
New/Add SFF_ Remodel SF�—
Garage/New/Add F—
Valuation $ U
Material/Laborca Zl 11Z.
OWNER'S NAME Last
First
Owner's Address
Owners E-mail Address
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City pState Ct't
Zip j,��, Telephone N[1 ijSo- C}Z
APPLICANT'S NAME Last
First��r�
Applicant's Address
Applicant's E-mail Address
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City :\ � � State I C'>l-
Zip �Zkr`'I Telephone �L--6qZ, 15`l-z,7
ARCHITECT/DESIGNER'S NAME Last ` �t_VLSC,.f1
First G— Lic. No. �—
Architect/Designer,'s-`A_ddress
Architect/Designer's E-mail Address
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city � ` F � � State Cy&
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ENGINEER'S NAME Last
First F Lic. No.F--
Engineer's Address
Engineers E-mail Address
City State F—
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
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City State Ce"
Zip ��) Telephone 1...r 15-r
SETBACKS REAR SETBACKS FRONT
PERMIT Norft .,'
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK NO.f C „ V • 13
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $