HomeMy WebLinkAboutXR2023-0346 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application °,«Re
F_ Comm'I F_ Residential City of Newport Beach - Building Division yn
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL '\I� aU�.3" 03% ��
F—Building F_ Grading r"Drainage
(—Elec F_Mech Plum Cu Yd Cut Cu Yd Fill)
Project Address (Not mailing address) F_ Flood F_ Fire j— Liq F_ Landslide FN/A Floor Suite No
Description of Work
Use F_ ConstType
�11ti(—
#Stories #Units (if Res)
Valuation $
Material/Labor
/ - r
New/Add SFF_ Remodel SF�— Garage/New/Add F—
OWNER'S NAME Last F&d
First (�] )�/,
Owner's Address
Owner's E-mail Address �U/�
]
City C/�cvA� � no^ r
State 1� Zip Telephone
" v `
7
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
i T -
Cit
State Zip I//f l } tl Telephone
ARCHITECT/DESIGNER'S NAME Last
First F Lic No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F Zip [ Telephoner
ENGINEER'S NAME Last
First LicNo.F—
Engineer's Address
Engineer's E-mail Address 633L4 7
City
State Zip F— Telephoner
CONTRACTOR'S NAME/COMPANY
F Llc.No. C{Cgqn Class
Contr ctor's Address
Contractor's E-mail Address
Ci t�
State F Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �>C7t�-�3
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $