HomeMy WebLinkAboutXR2023-1153 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application
F_Comm'I F-Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building [- Grading [-Drainage i- Elec [- Mech [- Plum Cu Yd Cut F_Cu Yd Fin F_
Project Address (Not mailing address) r Flood [- Fire [- Liq [- Landslide rN/A Floor Suite No
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Description of Work
Use F Const Type F
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# Stories #Units (if Res)
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Valuaf($q
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New/Add SF_
Garage/New/Add—
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OWNER'S NAME Last
First
-- -
Owner's Address
- - - -
Owners E-mail Address
City
--
State
zip F_ TelephoneF_
APPLICANT'S NAME Last
_ First
Applicant's Address
Applicant's E-mail Address
City _
State �— Zip F_ TelephoneF—
ARCHITECT/DESIGNER'S NAME
Last First F— Lic. No. �—
ArchitecUDesigner's Address
ArchitecUDesigner's E-mail Address
City
State — Zip F Telephoned —
ENGINEER'S NAME Last
First F— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State �— Zip F_ Telephoner
CONTRACTOR'S NAME/COMPANY
Lic. No.
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Contractor's Address
Contractor's E-mail Address
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City *
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State �k Zip yj Telephoned--
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. �(, 2Zt17�3 �153
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 112 a • ZQ L'f
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ = •