HomeMy WebLinkAboutPV2023-0009 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
F- Comm] (XResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F- Flood i- Fire F_ Liq r Landslide FN/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)F_
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Valuation $ 2�
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OWNER'S NAME !, ,^�—
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Owner's
Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First Lic. No. lam°I°I a�3
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Architect/Designer's Address ( j �'Q-4 2.
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last First I rV Lic. No.
Engineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY �I k rlr bl w % 0 L Lic. No.' W/9 j>'7 Clas q
Contractor's Address
Contractor's E-mail Address
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City I jy t%l.e_ State 71
Zip I 40(e ➢ Telephone g) �2
SETBACKS REAR SETBACKS FRONT
PERMIT NO. TN4zDV3,poo°I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. (gyp (yj, d�9jC�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $