HomeMy WebLinkAboutPV2023-0468 - Permit ApplicationPrint Form _ WVorksheet for Combo Building & Solar Permit Application
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F COmm'I r Residential City of Newport Beach - Building Division t14 6
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood r Firer Liq r Landslide I —N/A Floor Suite Nc
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Description of Workinolz
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OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State F_ Zip F_ TelephoneF�
APPLICANT'S NAME Last
Applicant's Address��
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ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
First
Applicant's E-mail Address
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zip Telephone is/_Z�J._ 9,55
First I Lic. No. F—
Architect/Designer's E-mail Address
City
State F_ Zip F— Telephone[�
ENGINEER'S NAME Last
First F� Lic. No.F—
Engineers Address
Engineer's E-mail Address
City I State F_Zip 0— �Telephone
CONTRACTOR'S NAME/COMPANY 01 3
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Contractor's Address u�-Fl �Co�actor's E-mail Address 6
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. 47U1B�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �Ii2zJ�
USE ZONE DEVELOPMENT NO - ni AK1 .1'Y Its