HomeMy WebLinkAboutXC2023-0218 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Comm'I City of Newport Beach -Building Division
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Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o�_..
'Building Grading []Drainage )FJec �vlech plum Cu Yd Cut l I Cu Yd Filll I
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Project Address (Plot mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑IN/A Floor Suite No
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Description of Work
Use atlonst Type t� i
H Stories I f N Units (if Res) -11
Valuation $
Material/Labor 1/
New/Add SF Remodel SF 7j 1,5 I Garage/New/Add
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OWNER'S NAME Last �'ViNri �ljZ First
Owners Address Owner's E-mail Address
City y�/V �i State Zip y Telephone
APPLICANT'S NAME Last M— _ I First M
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Applicant's Address Applicant's Email Address
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y 7 — — �[, p f yTelephone[ 1
Cit Q% Gli=i- � State Cj'� I Z Z (7/J Z• 1�
Last �)\ (f�,(>� (� Lic. No. G i
ARCHITECT/DESIGNER'S NAME >kArchitDesigners
Architect/Designer's Address -mail Address
City ) y��z0� �zi�j� State (/ � Ziphone ��b
ENGINEER'S NAME Last _ First — _i Lic No.�—�
Engineers Address Engineers E-mail Address
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City State Zip l Telephone l
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CONTRACTOR'S NAME/COMPANY I V� pt'1� Lic.No. �—� ClassF 1
Contractors Address Contractors E-mail Address
City Slate F7771, Zip Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NOO-�j�/3
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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