HomeMy WebLinkAboutPV2023-0264 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application o�m
F_ Comm'I --{Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building i— Grading F-Drainage f`tlec r Mech r Plum CuYdCut s CuYdFill F
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
Use s Const Type s
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# Stories # Units (if Res)F—
Valuation $
Material/Labor
New/Add SFF Remodel SFF— Garage/New/Add F—
OWNER'S NAME Last I jc) Vet ) First
Owner's Address Owner's E-mail Address
City E ��Z { \ State ss ZIPF(V 6LK,) Telephones
APPLICANTS NAME 1
Last C_,•'t,V) �_}�, ` First
Applicant's Address Applicant's E-mail Address
_..� �I - � I �•�c„ �'f VL�,. G �_L �lY �•4-+iI
City L _ 2�Lo Telephone it t ck (o 7 7(e i j (+
-L v" ��ti c- cn State ✓!�Zlp c
ARCHITECT/DESIGNER'S NAME Last First —Lic. No.
Architect/Designer's Address Architect/Designees E-mail Address
City I State F Zip F_ TelephoneF_
ENGINEER'S NAME Last First F_ Lic. No.F
Engineer's Address Engineer's E-mail Address
City I State � Zip I Telephone[ —
CONTRACTOR'S NAMEICOMPANY j k.N I S } I G y Lic. No. T t i-E 7r{S Gass
Contractors Address Contractor's E-mail Address
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City U �, State L- Zip R L 4 Telephone 1C L�( " / (� +Z.
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKSLEFT SETBACKS RIGHT PLAN CH
USE ZONE DEVELOPMENT NO PLAN CHEC FEES $