HomeMy WebLinkAboutXR2023-0931 - Permit Application'nt Form I Worksheet for Combo Building & Solar Permit Application Old
W°�aComm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF S
rBuilding r Grading
UBMII L
j—Drainage r Elec r Mech r Plum Cu Yd Cutl Cu Yd Fill
Project Address(Not mailing address) r Flood r Fire r Liq F Landslide rN/A Floor Suite No
Description of Work
Use ConstTypeF
Stories #Units (if Res)
Valuation $
Material/Labor F�
�r
New/Add SFF —
Remodel SF — Garage/NewlAdd �—
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State F—
ZIP [_ Telephoned --
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State �— Zip F— TelephoneF�
ARCHITECT/DESIGNER'S NAME
Last First F� Lic.
No. F—
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State �— Zip F_ TelephoneF�
ENGINEER'S NAME
Last First F —Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State �— Zip Telephone---
ZVr'
CONTRACTOR'S NAME/COMPANY
`;. .. i i Lic. No. l j Class
Contractor's Address
d'ontractor's E-mail Address
1 �'AL-
vo
City It V ``I / A
State zip I1
- (�— P��J Telephone !
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $