HomeMy WebLinkAboutXR2023-2445 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application r EWPo"'e
City of Newport Beach -Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V n
rBuilding F_ Grading [—Drainage F_Elec F_Mech F— Plum CuvdCut CuVdFill
Project Address (Not mailing address) F_ Flood F_ Fire F Liq i— Landslide FN/A Floor Suite No
�y 8A u 1 � f
Description of Work Q C`�Ij L�G r 36 LF ! / `.��f T-V -4 Use I- ConstType F_
��%'Iu/ ��WLOt —1b L r��GT u # Stories[— # Units (if Res)F_
Valuation $ /
New/Add SF� Remodel SF � Garage/New/Add Material/Labor l
OWNER'S NAME Last
V LyFF� First
Owner's Address _ Owners E-mail Address
CityFN V State � Zip Telephone
g 32.5 ff/
APPLICANT'S NAME Last
Applicant's Address
City - State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address [ `
l8682 Pb4eA1aVz-
City Tk�r/x) State I `�K -
First
Applicant's E-mail Address
Zip � Telephoner
First Lic. No.
Architect/Designer's E-mail Address
Zip 9l ; 0a Telephone11� 7l �%C,3
ENGINEER'S NAME Last First
Engineer's Address Engineer's E-mail Address
City State I Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Lic. No.F_
Lic No. Class
Contractor's E-mail Address
State F Zip F Telephoned
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
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PLAN CHECK NO.
PLAN CHECK FEES $