HomeMy WebLinkAboutXR2023-3203 - Permit ApplicationPrim Form Worksheet for Combo Building & Solar Permit Application orEWPo e
Comm'I Ftl residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL'
uilding [- Grading [—Drainage [- Elec [- Mech
( Plum Cu Yd cut Cu Yd Fill F
Project #ddress (Not mailing address) [- Flood
[- Fire [- Liq [- Landslide [-N/A Floor Suite No
Description of Work Ir729/f ,[C-
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L- A S /4C a ZValuation$New/AddSF
Material/Labor
Re ISF 6� Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owners E-mail Add
City State F
Zip F— Telephoned
APPLICANT'S NAME Last
First //q /�!
/Addrdss
Applicant's Address
Applicant's E-mail
City L%?k1 1 A: G/+/V//) State �/!
Zip Z� . �' Telephone
ARCHITECT/DESIGNER'S NAME Last )ACz-( First 7i �r<i Lic. No. `` ^
Architect/Designer's Address
Architect/Designer's E-mail Address
A S r,G Ile -
City State �—
Zip F Telephone[
ENGINEER'S NAME Last
First F Lic No.1 "
Engineers Address
Engineer's E-mail Address
City State F_
Zip F TelephoneF_
CONTRACTOR'SNAIVIE/COMPANY
Lic No. yJ`?97 Class
Contractor's Address
Contractor's E-mail Address
City I State
Zip � Telephoned—
SETBACKS REAR SETBACKS FRONT
-
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. iiUial�� ��P
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $