HomeMy WebLinkAboutM2023-0084 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUg,{Il( j W% 1A/nr.-) I
r Building F_ Grading l-Drainage F Elec (- Mech r Plum Cu yd
t Address (Not mailing address) F Flood r Fire F-
bSiU -mr,
HARBOR PEWIT
Landslide F_N/A Floor Suite No
OF NEVVPPF'; - ,
Use F ConstType F
--e .FI w w ., --
# Stories # Units (if Res)[-
_ l
Valuation $
New/AddSF1 Remodel SFF — Garage/New/Adds Material/Labor
OWNER'S NAME Last NIr
Owners Address
3 5 Seal l\t C. -D V -
City I 5�A V, FV; t, . \_ i k r`�CCZ State FC A
APPLICANT'S NAME Last
Applicant's Address
City �i{--/mac,State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
First d
Owner's E-mail Address
Zip Telephone) —-
First
Applicant's E-mail Address
Zip C�;Z�Telephone%
First r — Lic. No, r—
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Architect/Designer's E-mail Address
City I State Zip [_ Telephone[ —
ENGINEER'S NAME Last I P - First n Lic No/ q L(
Engineer's Address
City ( State`
J
Engineer's E-mail Address
Zip CLTelephone[]
CONTRACTOR'S NAME/COMPANY `. ilk, t V\C Lic No.. (l( 3Cr Class
Contractors Address Contractor's E-mail Address
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r�1V�czCt< C)cti j
City l u State.'{ Zip (�-�2� Telephone Cj 1' j C(�'-�j 3S�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
PLAN CHECK NO. { (] gL
DEVELOPMENT NOPLAN CHECK FEES S