HomeMy WebLinkAboutF2023-0072 - Permit ApplicationL Pr� Worksheet for Combo Building & Solar Permit Application �E°gr
F Comm'I r Residential City of Newport Beach - Building Division y� t
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Buildin j�
g r Grading Drainage Irclec (rMech Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not rrlaHing address) Flood F_ Fire J_ Liq r Landslide I —N/A Floor Suite No
Description of Work
Use ConstType vg
# Stories #Units (if Res)
New/Add SF�— Remodel SF
�� Garage/New/Add �—
l �P
Valuation $
Material/Laborf ([
OWNER'S NAME Last L�
/1>V1Z�� First
Owner's Address
(y Owner's E-mail Address
City QQ State
' fJ• I % T ZiP Telephone—
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State Zip Telephoner
ARCHITECT/DESIGNER'S NAME Last `
_ � First �— Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
--- - -------
city State �— Zip Telephoner
ENGINEER'S NAME Last First Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State �® Zip �— TelephoneF
CONTRACTOR'S NAME/COMPANY / I n (C Lic. No.%�— Class
C� f V
Contractor's Address
Contractor's E-mail Address 1 V�
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City
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l�L State Zip
W�t l t3 64 3 Telephone 9 Gr ��?--vZ 7l(
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SETBACKS SETBACKS FRONT PERMIT NO. y "2,7- �13
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. IL2�yy ,,L
USE ZONE �'
DEVELOPMENT NO PLAN CHECK FEES $