HomeMy WebLinkAboutXC2023-0330 - Permit ApplicationPrint Form
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Project Address /(Note mailing address) ❑ Flood ❑Fire ��i LLirq � Landslide (;N/A Floor Suite No
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Description of Work Use Rp'_-�ticonstType til
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Valuation $ / r,
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OWNER'S NAME( Last First
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Owner's Address Owner's E-mail Address
City � � State �G I Zip [ - Telephone
APPLICANT'S NAME Last-- _-�---_-.-_-�� First
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Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME I> > 6j Lic. No. z (K Gr.�-
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ENGINEER'S NAME Last First Lit No.�;_
Engineer's Address Engineers E-mail Address
Telephone
City State Zip Tele P
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CONTRACTOR'S NAME/COMPANY t /"tip i .f 1�� --7
Contractor's Address Contractors E-mail Address
City State— ZIP F—,, TelephoneF-
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SETBACKS REAR SETBACKS FRONT PERMIT NO. MC43= O !'
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No 101-3 O6t
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 606�'r a 3
Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE PI AN CHECK FEES DUE AT TIME OF SUBMITTAL
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