HomeMy WebLinkAboutXR2023-1070 - Permit Applicationr.
Print Form W eet for Combo Building & Solar Permit Application
F_ Comm'I j j�Residentia City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL M13 _ 100 oa .
F Building (-Grading rainage F_Elec F_Mech Vv CuvdCut F_ CuvdFinF v
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Project Address (Not mailing address) C Flood F_ Fire LrN F_N/A Floor Suite No
Work of Description
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#st ie's � #Units (if es '
Valuation $ / )�
Material/Labor
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New/AddSFF Remo/delSF1 Garage/New/AddF
OWNER'S NAME Last �L'N �e;i_ /' #& First
Owner's Address Owner's
Owner's E-mail Address f
City ( 1'/fJ(Z A5;1K71 State 77 Zip 7�;0 Telephone'7--H �}(IU%(X-'?-
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— Zip Telephoner
ARCHITECT/DESIGNER'S NAME Last 'Q, First / _ ic
Archite signer's Address Architect/Designer's E-mail Add v
City State F Zip F Telephones
ENGINEER'S NAME Last F First F� Lic. No.F—
Engineer's Address Engineer's E-mail Address
City F ' C f , 1 ' ^ Zip �— TelephoneF
CONTRACTOR'S NAME/C MPANY �fVA,v1
AP�� Lic No. Class
Contractor's Address Contractor's E-mail Address
ZoZ SAN 4A AUK S (wrnAt�G.Di;J Mn1�.�eVl .
City �WP6)r2-i State Zip Telephone D/ 35,}2
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SETBACKS REAR SETBACKS FRONT PERMIT NO. "I ' -
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK 0.
USE ZONE DEVELOPMENT NO f?jPLAN CHECK FEE