HomeMy WebLinkAboutPC2023-0876 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4�Ew�
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(- Comm'I >I!ksidential City of Newport Beach - Building Division �r �0�3� of"ro0."
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL li
F- Building r- Grading
rDrainage r�,Elec r Mech r Plum CuvdCut F cuvdFill F
Project Address (Not mailing address) (- Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
Use F—Const Type F
P, rz
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# StoriesF— # Units (if Res)
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Valuation
New/Add SFF—
Remodel SFF— Garage/New/Add F—
$
Material/Labor
OWNER'S NAME
Last �- G�,�;,x First
Owner's Address
Owner's E-mail Address
City
State Zip F_ TelephoneF—
APPLICANT'S NAME
Last �'cs First
Applicant's Address
Applicant's E-mail Address
City
State Zip `� Z;3 7, Telephone -? \Q �(z S 1 "7 v?,
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City r—
State F_ Zip [ TelephoneF—
ENGINEER'S NAME
Last First F_ Lic. NoF_
Engineer's Address
Engineer's E-mail Address
City
State I— Zip I Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. }b "i (, 7 t , Class y(' I C ,
Contractor's Address
Contractor's E-mail Address
City ,�-,,.�i
State h Zip Telephone 1t y >377',�L
SETBACKS REAR
SETBACKS FIRF T PERMIT NO. yr CCJi<,!7 -- UL Z'�'
SETBACKS LEFT
SETBACKS RI H PLAN CHECK NO. \ L 7iU�✓ ��
USE ZONE
DEVELOPMEN 0 PLAN CHECK FEES $