HomeMy WebLinkAboutPV2023-0108 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4�EW�,e
r Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F_ Grading rDrainage rElec FMech
FPlum Cu vd Cut Cu vd Fill
Project Address (Not mailing address) F_
r Fire F_ Liq r Landslide r_N/A Floor Suite No
Z stirs c-�
Description of Work
Use ConstTypeF
�`��
,0NW gC `ri� 1.10
%M�
# Stories #Units (if Res)
New/AddSFF— Remodel SFF Garage/New/Addy—
Valuation $
Material/Labor"
OWNER'S NAME Last
First
Owner's Address
Owners E-mail Address
City State F
Zip F_ TelephoneF_
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip �— Telephoner —
ARCH ITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip [ Telephone�—
ENGINEER'S NAME Last
First 7— Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City State F—
Zip �— Telephone[ —
CONTRACTOR'S NAME/COMPANY 70� N� Lic. No. q%� Class C [J
.Y
Contractors Address
Contractor's E-mail Address
City ✓ WNW % State �
/
Zip 2 yl Telephone S r 2,0
GG[ ° ,z3�o //O
SETBACKS REAR SETBACKS FRONT
PERMIT NO. V To J' O IO s
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ' (, jAt.5.6gp Z
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $