HomeMy WebLinkAboutPV2023-0190 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application o4�EW�am
j- Comm'I r Residential City of Newport Beach - Building Division j
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading
rDrainage r Elec r Mech r Plum CuYdCut F CuYdFill
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use F—Const Type F_
`�co MCut-. %
sc�l6fir 1v5ir �<i.%5t'I<jt7
# Stories # Units (if Res)s
Valuation $
New/Add SFF
Remodel SF F— Garage/New/Add
Material/Labor
OWNER'S NAME
Last �Y2 ��'L First
Owner's Address
Owners E-mail Address
City
State �— Zip �— Telephoned_
APPLICANT'S NAME
Last vp [ 1 i o+ First �To J o
Applicant's Address
Applicant's E-mail Address
City �—
State f - Zip F_ Telephoner—
ARCHITECT/DESIGNER'S NAME Last �— First Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F—Zip �— Telephonel—
ENGINEER'S NAME
Last �— First Lic. No.r
Engineer's Address
Engineer's E-mail Address
City r--
State F— Zip I— TelephoneF—
CONTRACTOR'S NAME/COMPANY CSof Lic No. F140 j Class &I C)
Contractor's Address
�J Contractor's E-mail Address
City
State F Zip I Telephgn��
SETBACKS REAR
n
SETBACKS FROG ,�,� PERMIT�Ni/OO.. �►U/f� Q 1
SETBACKS LEFT
SETBACKS RIGHV T�^}1�V(�-,�� PLAN CHECK N
USE ZONE
DEVELOPME O PLAN CHECK FEES $