HomeMy WebLinkAboutXR2023-0231 - Permit ApplicationL print Form Worksheet for Combo Building & Solar Permit Application ozEWP°°}R\B
Fcomm"f Residential City of Newport Beach - Building Division!
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F Grading
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Project Address (Not
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Description of Work
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# Stories # Units (if Res) '9U
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Valuation $
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New/Add SF
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OWNER'S NAME
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Owner's Address
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City
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APPLICANT'S NAME
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last 3, k First s7e jr' f Lic. No. G 1 z r 2 y
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Architect/Designer's Address
ArchitecdDesigner's E-mail Address
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ENGINEER'S NAME
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Engineer's Address`
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY Lic. No. S6� �6 Classy
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Contractor's Address
Contractor's E-mail Address
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City
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State
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SETBACKS REAR
SETBACKS FRONT (�I`�V L)—iPERMITNO. —�%�Q
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. _jt'LQ .22*$
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $