HomeMy WebLinkAboutXR2023-0850 - Permit ApplicationL Print Form_ Worksheei for Cornbo Building & Solar Permit Application
Comm'I r Residential City of Newport Beach - Building Division
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[—Building F_ Grading 7Drainage F_Elec Mech F Plum Cu Yd Cutl Cu Yd Fill F
Project Address (Plot mailing address) F Flood F_ Fire F7 Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use ConstType F
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# StoriesF # Units (if Res)F—
Valuation $F�
Material/Labor
New/Add SF�— Remodel SF�— Garage/New/Add �—
OWNER'S NAME Last First
Owners Address Owner's E-mail Address
City State �—
ZIP F_ Telephone—
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State F Zip F TelephoneF�
ARCHITECT/DESIGNER'S NAME Last First F_ Lic. F�
No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip �— Telephone�—
ENGINEER'S NAME Last First® Lic. No.�--
Engineer's Address Engineer's E-mail Address
City State Zip F— Telephone
CONTRACTOR'S NAME/COMPANY // Z
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Contractor's
Contractor's E-mail Address l>73u0 S UdU
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City ` e Cl State FC0 - Zip /r-7L ) Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO. S O
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO,
USE ZONE DEVELOPMENT NO PLAN CHECK FEES R