HomeMy WebLinkAboutXR2023-2406 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding F Grading rDrainage (—Elec
Project Address (Not mailing addre!
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Description of Work
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New/Add SF F_ Remodel SF
OWNER'S NAME Last
Owner's Address
City
APPLICANT'S NAME Last
Applicant's Address
City
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City
ENGINEER'S NAME Last
Engineer's Address
City
CONTRACTOR'S NAME/COMPANY
Contractor's Address
-ity
State r
Gfa �
Last
State F
I� t
r Mech r Plum Cu Yd Cutl Cu Yd Fill F_
r Flood F Fire r Liq F Landslide rN/A
Floor Suite P
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Garage/New/Add F—
First
Owner's E-mail Address
Use I— ConstType F_
# StoriesF— # Units (if Res)F
Valuation $ FW1
, `/ 1Material/Labor060
ZIP [_ Telephoned --
First) UaIe
Applicant's E-mail Address
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Zip - Telephone
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First �— Lic. No. �—
Architect/Designer's E-mail Address
State F ZiP �— Telephone[—
First
Engineer's E-mail Address
State F Zip I Telephone
Lic. No.F�
Lic. No.F Class
Contractor's E-mail Address
State �— Zip [� Telephone[�
SETBACKS REAR SETBACKS FRONT PERMIT NO. viD1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT Nn of n e I is ___„ m