HomeMy WebLinkAboutXR2023-0883 - Permit ApplicationPrifitForm Worksheet for Combo Building & Solar -Permit -Application
City of Newport Beach - Building Division
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Suite No
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Description of Work Use / 1Const Type F-13 �7
StoriesT # Units (if Res)F_
Valuation Sol oc�o
New/Add SF Remodel SFF�� �_57' Garage/New/AddF Material/Labor
OWNER'S NAME Last GO First
Owners Address owner's E-mail Address
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APPLICANT'S NAME Last Firstj
Applicants Address Applicant's E-mail Address
City State 5��-Zip PZ TelephoneF
ARCHITECT/DESIGNER'S NAME Last First �4r+fS Lic. No. F-F-1 377
Architect/Designees Address Architect/Designers E-mail Address
Zip �4��3 Telephorej
City State F_��_
ENGINEER'S NAME Last First Lic.47- �V�IW
Fl��A-46!104 Fq -5-7
Ennineei's Address Engineers E-mail Address
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CONTRACTOFVS NAME/COMPANY 14 . t3l" Lic. No. Class _67
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Contractors Address Contractor's E-mail Address
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City State zip %-2 Telephon�5v)3yf -A;�bvl/ rvi; -JrAj
SETBACKS REAR SETBACKS FRONT PERMIT NO. MZ&23�0983
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO, PC
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $