HomeMy WebLinkAboutXR2023-3090 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
(- 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) I- Flood
r- Fire j- Liq i- Landslide rN/A Floor Suite No
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Description of Work
Use F—ConstType F-
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# Stories1 # Units (if Res)l3
Valuation $ �A
Material/Labor /
New/Add SF 1„'LL Remodel SF Garage/New/Add h �-
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OWNER'S NAME Last Ir9/7�frZ
First
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Owner's Address r � U C,
Owner's E-mail Address
City �t4� I State v
Zip I4roo Telephone
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APPLICANT'S NAME Last y
First
Applicant's Address
Applicant's E-mail Address
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City I jPq /.*_ 400 State
Zip lyo 3 Telephone le . 970. ,1 f ? f
ARCHITECT/DESIGNER'S NAME Last
First Lic. No. F--
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F__
Zip I Telephone
ENGINEER'S NAME Last �—
First 7 Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State F_
Zip I-- Telephoned
CONTRACTOR'S NAME/COMPANY G sht /_�
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I� � y Lic No. a �J[f r Class
Address
Contractor's Address
Contractor's E-mailil
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City �, State I
Zip 1 2t1 j Telephoned
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. •
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. •
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $