HomeMy WebLinkAboutXR2023-0032 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application o�
F- Comm I F_ Residential
City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI )OL Am I "an � c.'
— v
F—Building F-Grading F®Drainage F—Elec FMech F—Plum CuvdCut s CuYdFill
Project (Not mailing address) C Flood F— Fire F- Liq F- Landslide FN/A Floor Suite No
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Description of Work
Uses Const Type s
�/ 1ao 4-2 /2/i
# Stories # Units (if Res)s
Valuation $ F
d(9�J
Material/Labor
New/Add SFF Remodel SF
Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State F Zip r— Telephone —
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip F Telephones—
ARCHITECT/DESIGNER'S NAME Last First I—
Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip F — Telephoner
ENGINEER'S NAME Last
First F— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City F_ State
zip Telephoner
CONTRACTOR'S NAME/COMPANY
Lic. No. �— Classs—
Contractors Address
Contractor's E-mail Address
City State
Zip F_ Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $