HomeMy WebLinkAboutXR2023-1348 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application R.
tt •"- EVIPO
F Comm'I r Residential City of Newport Beach - Building Division t
F��
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALing F Grading rDrainage r Elec r Mech j_
r Plum Cu Yd Cut CU Yd Fillct Address (Not mailing address) f Flood r Fire (- Liq r Landslide rN/A
Floor Suite No
Description of Work
New/Add SF ;
Remodel SF
l J5�21 S1
OWNER'S NAME ` r
Last I
Owner's Address
Use F Const Type F
# StoriesF_ # Units (if Res)F_
Garage/New/Add j :—:j (valuation$ h[
Material/Labor '?
First •, �- -,�®+� �
-- Owner's E-mail Address
City State F_ _
Zip
Telephone�—
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City F State F— Zip F— Telephonel----
ARCHITECT/DESIGNER'S NAME
Last v; 4 w �r First F —
ArchitecUDesigner's Address Lic. No. F---
ArchitecUDesigner's E-mail Address
City
State F' Zip F TelephoneF-
ENGINEER'S NAME Last
First F — Lic. No
.�—
Engineer's Address
Engineer's E-mail Address
City State r---
ZIP TelephoneF�
CONTRACTOR'S NAME/COMPANY
Lic. No. F� Class
F
Contractor's Address
Contractor's E-mail Address
City F State F— �~
Zip [_ Telephoned---_
SETBACKS REAR SETBACKS FRONT �/
�--- PERMIT NO. x/`-ZOZ:���
SETBACKS LEFT �—
SETBACKS RIGHT PLAN CHECK NO. C 0,z
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $