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HomeMy WebLinkAboutXR2023-0720 - Permit Applicationgr�2oz� --a7zo Print Form_ Worksheet for Combo Building & Solar Permit Application C_<omm'I F_t�sidential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL PKilding F_Grading f—Drainage F_Elec Description of Worki New/Add SFF-- %J'eyy/A 6,f /45—12W.A7/49L [Mech F Plum Cu Yd Cut l Cu Yd Fill Flood r Fire j.- Liq r Landslide _N/A Floor / S/,� Garage/New/Add F— OWNER'S NAME Last/f /���' C!/ First Owner's Address Owner's E-mail Ad City _--� State Zi _ p Suite No 4 Use 4— 7UConstType # StoriesR # Units (if Res) Valuation $ Material/Labor /T1027 of APPLICANT'S NAME Last / ��LI/�� First V �- `/ Applicant's Address Applicant's E-mail Address �GI %z G4 AC i7vF !/ �/,f fc zdl d��`id�� Co City /�� - <<— �'%� dA /SG AVID State �— _ l _ /� Zip `�� Z Telephone ARCHITECT/DESIGNER'S NAME Last � �/V j f�e j }�� i lI �L 5 Architect/Designer's Address First Lic. Noll E-mail Address Ss-P"t-- a✓�z city State ip Telephone ENGINEER'S NAME Last First �� Lic. No. Engineers Address Engineer's E-mail Address C ity CONTRACTOR'S NAME/COMPANY Contractor's Address City State F ZIP F Telephone[_ — State F Lic. No. �l �� ClassF Contractor's E-mail Address Zip F Telephoned® SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE nFVFi r)Pry r:K[T kin PERMIT NO. ' / ` PLAN CHECK NO.