HomeMy WebLinkAboutREV2023-0588 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application V �s
� Comm'I rJ'Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES nl IF AT TlnnF nF rsi icmnirrAi
Fy;4uilding F_Grading F-Drainage F_Elec F-Mach F_Plum CuYd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide f N/A Floor Suite No
Description of Work
Use Const Type
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# Stories # Units (if Res)s
f
Valuation $
Material/Labor
New/Add SFs— Remodel SF F7 Garage/New/Add r
OWNER'S NAME -
Last
Owner's Address
Owner's E-mail ddress
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cityi.. - F /
j State ��. Zip , ' Tele hone ' J' c
APPLICANT'S NAME Last > /E ��eel� First
Applicant's Address Applicant's E-mail Address
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Cit
Y ✓� - State
�� C7i ZIP Telephone '7r,�t
ARCH ITECT/DESIG N E R'S NAME Last First—
Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip F— Telephoner
ENGINEER'S NAME Last First Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State Zip F_ TelephoneF—
CONTRACTOR'S NAME/COMPANY � � Lic No. F_ Classs
Contractor's Address Contractor's E-mail Address
City State F Zip F Telephones
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Pt:�ZZ� 99
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $