HomeMy WebLinkAboutXR2023-2449 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r comm" Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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Valuation
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New/Add SF � Remodel SF I �� Garag e/New/Add
$ 7 7r 000
Material/Labor '
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
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State
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APPLICANT'S NAME Last
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First A1v�SSd\
Applicant's Address
Applicant's E-mail Address
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State F —(7—
Zip [ Telephone) I `�`i. ' -2W 3 - 3� 3 co
ARCHITECT/DESIGNER'S NAME
Last S;�yG(R Y
First Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last
FirstF Lic. No.F_
Engineer's Address
Engineers E-mail Address
City
State F_
Zip �— Telephoned
CONTRACTOR'SNAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
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State C P�
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SETBACKS REAR \ O \
SETBACKS FRONT ?�
PERMIT NO.
SETBACKS LEFT l9
SETBACKS RIGHT PLAN CHECK NO. �LZJZ 3 — Lt y
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $