HomeMy WebLinkAboutXR2023-0139 - Permit ApplicationI_Print Form j Worksheet for Combo Building & Solar Permit Application
F_ Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) C Flood r Fire f- Liq r Landslide CN/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)s
Valuation
Material/Labor
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New/Add SF J� Remodel SF Garage/New/Add
OWNER'S NAME Last First
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Owners Address Owner's E-mail Address
City N�� `� State �— Zip Telephones
APPLICANT'S NAME Last
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Applicant's Address Applicant's E-mail Address
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City IN ...Eeo Gh - State I Zip �— Telephone - s� -S7 ,`3
ARCHITECT/DESIGNER'S NAME Last First
_ Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip �— Telephoned --
ENGINEER'S NAME Last First F_® Lic. No.s--
Engineer's Address Engineer's E-mail Address
City State Zip Telephones —
CONTRACTOR'S NAME/COMPANY 9� n �cr^�] Lic SNo. c6q L%r75 Class
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ctors Addr�egss Contractor's E-mail Address
City State /� Zip Telephone i 5)
SETBACKS REAR SETBACKS FRONT PERMIT NO. Ya7`jjZ_S -01�q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. rC2�02 --(+
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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