HomeMy WebLinkAboutXR2023-0264 - Permit ApplicationComm'I Worksheei for Corrib-c- Building& Solar Periffilt'Applicaff6h
F Residential (00,c> 3� City of Newport Beach - Building Division
oi416 NOTE: PLAN CHECK FEES DUE AT TIME OF CHDRA11
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Project Address (Not mailing address) F_ Flood F,_ Fire F_ Liq F_ Landslide F7N/A Floor Suite No
Description of Work
Use Const Type
# StorlesF7 # Units (if Res)-New/Add SFF- Remodel SF Valuation $ bor
Garage/New/Add F Material/La
OWNER'S NAME Last
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Owners Address
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APPLICANT'S NAME Last First
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Applicant's Address Applicant's E-mail Address
City State Zip Telephone[
ARCHITECT/DESIGNER'S NAME Last F�CaQ-TLm First Lic. No.
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Architect/Designer's Address Architect/Designees E-mail Address
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City 111: - FC6 Zip Telephone
ENGINEER'S NAME LastF� FirstF_ Lic. No.F-
Engineers Address Engineer's E-mail Address
City State F_ Zip Telephone F
CONTRACTOR'S NAME/COMPANY Lic. No. F-ClassF_
Contractors Address Contractor's E-mail Address
City F� State F_ Zip TelephoneF
SETBACKS REAR SETBACKS FRONT PERMIT NO. )(4q6
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. f q(/�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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