HomeMy WebLinkAboutXR2023-2303 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I FV, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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act Address (Not mailing
Description of Work
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Suite No
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OWNER'S NAME
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Owner's Address
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APPLICANTS NAME Last T _
Applicant's Address
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Valuation $
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Owner's E-mail Address
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Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last F— First —
Lic. No. �—
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City I State F— Zip F— Telephone F_
ENGINEER'S NAME Last
First F� Lic. NoF_
Engineer's Address Engineer's E-mail Address
city I State F_ zip F— Telephoned--
CONTRACTOR'S NAME/COMPANY /c,11- lcle;x�iCL/b� 1 1 Mt ka its ,lull icNo. �'�' 0 Class
Contractor's Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $