HomeMy WebLinkAboutXR2023-2341 - 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
%Building r Grading ("Drainage P(Elec r Mech r Plum Cu Yd cutl Cu Yd Fill F_
Project Address (Not mailing address) F Flood r Fire F_ Liq r Landslide FN/A Floor Suite No
1,PA'a A HOE— F F_
Description of Work
Use r— ConstType�
# StoriesF_ # Units (if Res)F-
Valuation $ Fu4if
Material/Labor O�
New/AddSF�— Remodel
SF /� Garage/New/Add—
OWNER'S NAME Last
% First I z-,kilk
Owner's Address
Owner's E-mail Address
�i� �1�S�vt�C Ate
Gl e_ lt„
City lJJz_af jA`yAF__
State PA Zip Telephone o/+gj 3jo09j4
APPLICANT'S NAME Last
First Gy<�
Applicant's Address
Applicant's E-mail Address
City GDP
State Fz�— ZipS TelephoneI{a05�
ARCHITECT/DESIGNER'S NAME
Last �— First F— Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
--
State Zip I Telephoned
ENGINEER'S NAME Last_
First �� Lic. No.I—
Engineer's Address
Engineer's E-mail Address
City � ��
State I V 5 — Zip O) Telephone n % -JJZ F7�;55
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City
State F Zip F— Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. RZO2 3o
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. l?GI3.2G 9
USE ZONE
DEVELOPMENT NO PR OB-O3IO PLAN CHECK FEES $