HomeMy WebLinkAboutPV2023-0465 - Permit ApplicationL Print Form J Worksheet for Combo Building & Solar Permit Pplication
Comm'I r" Residential City of Newport Beach - Building Divisionob
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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rBuilding (- Grading F-Drainage F_ Elec r Mech r plum CuYdCut F_ CuYdFill F_
Project Address (Not mailing address) F_ Flood r- Fire r Liq r Landslide FN/A Floor Suite No
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Description of Work
Use F—Const Type
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# Stories # Unit s)�
Valuation $
Material/LaborZ�
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New/Add SF Remodel SF
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Garage/New/Add �-
OWNER'S NAME Last
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First v \ O �1
Owner's Address
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Owner's E-mail Address
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City Y� �rg _ C State �— Zip q�,J1 Telephone _ 2� , g' J1
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APPLICANT'S NAME Last yn S
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First
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Applicant's Address
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Applicant's E-mail Address
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City p\pnp►/1 State rC
Zip A Telephone 3g 5z u -1 3 q
ARCHITECT/DESIGNER'S NAME Last V\ o IDS First �Q1r— I V' 1 Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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City State F-
Zip Telephone - 2 1 Q -I j J `fl
ENGINEER'S NAME Last-r-t,,u�
Fir Lic. No.F—
Engineer's Address
Engineer's E-mail Addres
City State F—
Zip F-- Telephoned —
CONTRACTOR'S NAME/COMPANY J��e� tocA O r Lic. No. 1p &q �`3 Class��
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Contractor's Address
1D23 e Savnlor l-�
City �lnnnl/L�� State -
Contractc,'s E-mail Address
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Zip Ql�(_�I Te
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phone ��S,11t �U
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. `
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
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USE ZONE DEVELOPMENT NO 1,�ZQ {�jq>�_ PLAN CHECK FEES $ 240—