HomeMy WebLinkAboutXR2023-0124 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application uF�=
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F- Comml F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI c.
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F-Building [Grading f-Drainage F-Elec F_Mech F-Plum C, yd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire F- Liq (- Landslide FN/A Floor Suite No
71-
Description of Work
Use ConstType�
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o c�ilw — we.0 C�IArBt� IS%
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# StoriesF # Units (if Res)r
CIAO
New/AddSF_ RemodelSF�— Garage/New/Add—
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Valuation $ �
Material/Labor (7aO
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OWNER'S NAME Last First l pyri�S
Owners Address Owner's E-mail Address
City -EYpw✓ State C Zip r(�LS Telephone 7/��7yz�3�zZ
APPLICANT'S NAME Last �jGs�c� First �j or�/fiS
Applicant's Address Applicant's E-mail Address
City State F — l
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designers Address ArchitecUDesigners E-mail Address
City State �— Zip F_ Telephoned
ENGINEER'S NAME Last First Lic. No.F—
Engineer's Address Engineers E-mail Address
City State F Zip TelephoneF
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractors Address Contractor's E-mail Address
City State �— Zip Telephone)
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. P�9y Zoz 3-G t ?
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $'�� 1