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HomeMy WebLinkAboutXR2023-1013 - Permit ApplicationPrint Form j- Comm] _J Worksheet for Combo Building & Solar Permit Application F_ Residential City of Newport Beach - Building Division NOTFPI AN ruP(`V Dome ni IC n ------•�-•� � vi�Vr JV61VIIIIHL \�" F Building F_ Grading F-Drainage F- Elec r Mech (- Plum Cu Yd Cut Cu Yd Fill � `l Project Address (Not mailing address) 7 Flood r Fire r Liq r Landslide I —N/A Floor 6 1hvern:s5 Suite Nc Ln F_ F_ Description of Work ` Use F— Const Type # Storiesr— # Units (if Res)r- Valuation in 00 Material/Labor New/AddSF�--- Remodel SFr-- Garage/New/Add OWNER'S NAME Last First Owner's Address Owner's E-mail Address City r— State F_ ZiP F— Telephone --- APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State [-- Zip F_ Telephoner---- ARCHITECT/DESIGNER'S NAME Last F—First F_ Lic. r-- No. Architect/Designer's Address Arch! tect/Designer's E-mail Address City State F_ Zip F_ TelephoneF� ENGINEER'S NAME Last First F_ Lic. No.r-- Engineer's Address Engineer's E-mail Address City r State F_ Zip -- �— Telephoner CONTRACTOR'S NAME/COMPANY Lic. No. F_ Class Contractor's Address Contractor's E-mail Address City � (� _Zly \� Telephone SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT A.PERMIT NO. PLAN CHECK NO. USE ZONE _ DEVELOPMENT Nn nl Ahi 1­1 ­