HomeMy WebLinkAboutXR2023-1152 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
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FBuilding r• Grading
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Project Address (Blot mailing address) f Flood j— Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
Use ConstTypeF
# Stories # Units (if Res)F
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Valuation $�
Material/Labor
New/Add SF�—
Remodel SF�— Garage/New/Add �—
OWNER'S NAME
Last
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Owner's Address
Owner's E-mail Address
City
State r - Zip Telephone r� f 0
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APPLICANT'S NAME
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Applicant's E-mail Address
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City F `
State Zip � Z7 Telephone F61L+j D07
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ARCHITECT/DESIGNER'S NAME
Last
First F-- Lic. F--
No.
ArchitecUDesigner's Address
Arch itecUDesigner's E-mail Address
City
State F_ Zip [_ Telephone F_
ENGINEER'S NAME
Last First F_Lic. No, F_
Engineer's Address
Engineer's E-mail Address
City
State �— Zip r-- Telephone--
CONTRACTOR'S NAME/COMPANY
WiA�s Lic. No. � 5gblClass7
Co&Aeldt'Ue� Less
Contractor's E-mail Address
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City D�Z
State V" Zip ✓� 21 Telephone -7I 1,7W I
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ J