HomeMy WebLinkAboutXR2023-1689 - Permit ApplicationPrint Form y, Worksheet for Combo Building & Solar Permit Application
r Comm'I I y Residential City of Newport Beach - Building Division
!` NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading rDrainage r Elec r Mech l�
r Plum Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing
Description of Work
New/Add SFr
OWNER'S NAME
r Flood r Fire j— Liq F Landslide
Floor Suite No
Use Y/'y � ConstType FF/
''ii
# StoriesT # Units (if Res)F_
�— Valuation $
Remodel SF
Garage/New/Add �— Material/LaborFj/_1/7d
Last I First
Owner's Address
Owner's E-mail Address
II Vme#
City I f� f tIvo ✓, } 1� ,9/j y /h State ZiP F— Telephoner
APPLICANT'S NAME
Last I 4ch rl
Applicant's Address t 6 /
I/1/iA
City
State 1 '1 Zip
First I /a✓d4
Applicant's E-mail Address
�ffih/
I «z!, / TelephoneF—
A RCO 1l;Ffi T/DESIGNER'S NAME ��,
Last ri/ 7�/First/ Lic No. �—
rchi cUDesigner's Address G Architect/Desig/ne/r's(E- ail Address
PiW
City / mn/„ mil} / State /�— Zip Telephone
NAME Last
Engineer's Address
City
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
First
Engineers E-mail Address
Lic. No.F_
State �— Zip �— TelephoneF_
LicNo. F— ClassF—
Contractor's E-mail Address
State �— ZiP F TelephoneF—
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PLAN CHECK NOVA?kjl,02_-A
PLAN CHECK