HomeMy WebLinkAboutPV2023-0089 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application *1,4.57P
(— Comm'I Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)e
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Valuation $
Material/Labor $�Or�I.3S 00
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OWNER'S NAME Last p First
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Owner's Address
Owner's E-mail Address
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State Zip c� Z � 3 Telephone_
APPLICANTS NAME Last
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Applicant's Address
Applicant's E-mail Address
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City CIn\Y\O
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ARCHITECT/DESIGNER'S NAME
Last First 7 Lic. No.F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip Telephoned
ENGINEER'S NAME Last
F First F Lic. NoF_
Engineer's Address
Engineer's E-mail Address
City
Stale F Zip_ TelephoneF
CONTRACTOR'S NAME/COMPANY
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Contractors Address
Contractor's E-mail Address
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City
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. Qy ZO23' OO O `
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. QC1,013 - CNO
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $