HomeMy WebLinkAboutE2023-0125 - Permit Application�� rr''
Print Fo[m Worksheet for Combo Building $ Solar Permit �4pplication o��W�"'a
City of Newport Beach - Building Division
[ Comm'I Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI AL �.,�oa�•�
ilding [' Grading
[Drainage [Elec [Meth [plum Cu vd cut Cu Yd Fill
Project Address (Not mailing address) [' Flood [ Fire [ Liq [ Landslide [N/AFloor Suite No
4!4 Y If�
Description of Work '-
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# Stories�i #Units (if Res)
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Valuation $
Material/Labor />
New/Add SFF---
Remodel SF�- Garage/New/Add
OWNER'S NAME
Last Ca.0 i, 7 First
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Owner's Address
Owner's E-mail Address
City State Zip -KE Telephone f
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APPLICANT'S NAME
Last �First G�
Applicant's Address
Applicant's E-mail Address
City
State
zip l Telephon
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ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip Telephoner
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ENGINEER'S NAME
Last /�'Ti"��_--� FirstC Lic.No.�
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Engineer's Address
Engineer's E-mail Address
City �—
- State L� Zip Telephone[: —
CONTRACTOR'S NAME/COMPANYL o�� Lic. No. % ( C't7 / Class 17
Contractor's Address
Contractor's E-mail Address
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City
State F Zip 2Z. ( C? Telephone
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PI AN CHECK FFFR R