HomeMy WebLinkAboutPV2023-0472 - Permit Application` Jnt Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
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Project Address (Not mailing address) r Flood
r Fire r Liq r" Landslide Fi Floor Suite No
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Description of Work
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# Storiesa # Units (if Res)[-
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Valuation $
Material/Labors
New/Add SF�— RemodelSF�—
Garage/New/Add—
OWNER'SNAME Last
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Owner's Address
Owner's E-mail Addressf
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City
State I
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APPLICANT'S NAME
Last \ �r-� C
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First
Applicant's Address
Applicant's E-mail Addre�s(�s
City
State I / ! .1�
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Zip �lephone GM
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ARCHIT T/ GNER'S NAME Last
First � Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F—
Zip [ — Telephone�—
ENGINEER'S NAME
Last
First F Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State �—
Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY \
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Lic No. �— ClassF_
Contractor's Address
Contractor's E-mail Address
City
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State I
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SETBACKS REAR
SETBACKS FRONT)
PERMIT NO. PVa tag — O N 7,Z
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. oj3. t3q
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES S