HomeMy WebLinkAboutPV2023-0515 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application C-19P
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) [- Flood [- Fire [- Liq [- Landslide (_N/A Floor Suite No
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Description of Work
Uses ConstType s
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#Stories #Units (if Res)
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Valuation $
New/Add SFF --
Remodel SF s— Garage/New/AddF_
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Material/Labor[I(j G
OWNER'S NAME
Last I V,)C j First C c: "
Owner's Address
Owner's E-mail Address
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City
State C A- Zip G'L _Et - TelephoneF
APPLICANT'S NAME
Last m t - First
Applicant's Address
Applicant's E-mail Address
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State iE Zip �) I t �, Telephone � j �, _ f�]� �," - � � x -
ARCHITECT/DESIGNER'S NAME Last First Lic No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
State F_ Zip F— Telephones
ENGINEER'S NAME
Last First �— Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State F Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic No. u'v `i c t Class
Contractor's Address
Contractor's E-mail Address
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City ! , �. i.
State 7/•- Zip F� i Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $