HomeMy WebLinkAboutXR2023-2385 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I I— Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading rDrainage r Elec r Mech r Plum CuYdCutF CuYdFill F
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use F—Const Type F
# StoriesF— # Units (if Res)[ —
Valuation $
New/Add SF F_Remodel SF�— Garage/New/Add
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owners E-mail Address
City �
State F— Zip F Telephoned
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City
State F_— Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME
Last First F— Lic. No.
ArchitecUDesigners Address
Architect/Designer's E-mail Address
City
State I Zip F_ Telephoned
ENGINEER'S NAME Last
First F Lic. No.F
Engineer's Address
Engineer's E-mail Address
City __
State F_ Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY
[� Lic No. %F-z � Class �—
cn
Co ` f �rfi6 s
Contractor's E-mail Address
1—��
_` � I IG�Z Y-fK,AA 50',
,Z fl( V1C )C IC\ti( •CCh'1
City of(k ' tvv'E- State G Zip qNA I Telephone TL�313 Cc') )
l•
SETBACKS REAR
SETBACKS FRONT PERMIT NO. oay ) 2,3 . ,f -s
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 4_2G b 8 tf -
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $