HomeMy WebLinkAboutM2023-0012 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application caComm'I esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL- ,
F-Building [_Grading r-Drainage F_Elec (-Meth F-Plum CuYdCut 'QyW,
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Description of Work t
e ConstType
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# Stories_ _ # Units (if Res)
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Valuations
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Material/Labor r -3
New/Add SFs��
Remodel SF� Garage/New/Add �
OWNER'S NAME Last l L First
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Owner's Address Owner's E-mail Address
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Cityr7t rJ2� State I Zip FR Telephone
APPLICANT'S NAME LastFirst
Applicant's Address Applicant's E-mail Address
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city BQ�C.(h State �- Zip _ C( (c�. Telephone
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. �-
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip F— Telephoner
ENGINEER'S NAME Last ��-/ First � Lic No. C (olp 9 41-It
Engineer's Address Engineer's E-mail Address
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City j L)r%a fy RAC State �- Zip C{� Telephone
CONTRACTOR'S NAME/COMPANY Lic No. 1 ,7� l`C3 `l Class
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Contractor's Address Contractor's E-mail Address
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City l_bg, a State I Zip IFOYTelephone
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SETBACKS REAR SETBACKS FRONT UVJ PERMIT NO. �r(,7j pn 12
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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