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HomeMy WebLinkAboutXC2023-0313 - Permit ApplicationPrint Form Comm'I F Worksheet for Combo Building & Solar Permit Application Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building rGrading rDrainage XEIec rMech rPlum CuvdCut F cuYdFill � `r Project Address (Not mailing address) I— Flood (— Fire r Liq r Landslide I —N/A Floor Suite No Description of Work Use � Const Type I _ j IF Stories # Units (if Res)F_ /,et,, Valuationa Material/Labor ) j New/Add SF� Remodel SF �.� Garage/NewJAdd �— OWNER'S NAME Last First I Toery Owner's Address i jj i�-,� eI Owner's E-mail Address o TzN tl� City p State Zip X) C �`� Telephone APPLICANT'S NAME Last Applicant's Address et.,F ��f(� First i N ./ Applicant's E-mail Addre f'7I—( City State/1 Zip Telephoned ARCHITECT/DESIGNER'S NAME Last First —Lic. No.C3/-) 23 Architect/Designer's Address Architect/Designer's E-mail Address MS -A City 0 4. <,/'l State r Zip FJ/61�( Telephone 3%b .2'0 — �� / /First ENGINEER'S NAME Last / /j po� �� } fj LJ Lic No. Engineer's Address ���'f Engineer's E-mail Address C " /G SL;L TH K'r�• >�Y� ih�,,,. ;� f�.}te r%>1 i.�,r.r_ :��t City `> J y State Zip I%� is j' Telephone 3) c, 7L t j 7 /,7J CONTRACTOR'S NAME/COMPANY F Lic. No, I ClassF Contractors Address Contractor's E-mail Address City State �— Zip � Telephoned SETBACKS REAR / SETBACKS FRONT PERMIT NO. (/� Y�OQ�j�t) SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 16"200��� � USE ZONE '�K-12 DEVELOPMENT NO PLAN CHECK FEES $