HomeMy WebLinkAboutXR2023-2826 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I (- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j—Building i- Grading
f—Drainage r— Else F_ Mech r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F FloodF- Fire F- Liq r Landslide F_N/A Floor Suite No
F_ F_
O V
Description of Work
Use F—ConstType
# Stories #Units (if Res)
New/Add SF
Remodel SFGarage/New/Add
Valuation$ @<-
Material/Labor
OWNER'S NAME
Last �� First
Owner's Address
Owner's E-mail Address
City
State Zip F_ Telephoned
APPLICANT'S NAME
Last K=tT��L, First /
r.-L
Applicant's Address c) �_ C
,, - (2-;�L+ i_ L'tL ``Applicant's E-mail Address
I
City
State Zip F Telephoner E
ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State � Zip F_ TelephoneF_
ENGINEER'S NAME
Lat First Lic No.
Engineer's Address
,
1 - v-Engineer's
,' . E-mail Address
_ I
City
State F Zip I Telephoner
CONTRACTOR'S NAME/COMPANY
Lic No. Class / A
Contractor's Address
Contractor's E-mail Address
L�i,�
City Igw'tilwJ��
State ;_'� Zip T( ET,—/ Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. Z92A
X� ZQZ3�
SETBACKS. LEFT
SETBACKS RIGHT PLAN CHECK NO.?(,?.Q0 w 7
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $