HomeMy WebLinkAboutPV2023-0015 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application "4>
F Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building F_ Grading F-Drainage rElec rMech
F_ Plum CuYdCut CuYdFill
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Project Address (Not mailing address) I- Flood
r Fire r Liq r Landslide rN/A Floor Suite No
3� Coald¢Nro,l Aye . �n a ��
Moir 7z6zs
Description of Work
Use ConstType
1 / ,1
I .//Solt,, Py 44cd, IL.S W'7� MiC/'o i✓N/'Gltt�S R'D Ao, 'eed
# Stories # Units (if Res)[T
"?� rda T
I
I N,SIn
Valuation 9
New/Add SF , (,� Vw Remodel SF� � Garage/New/Add
Material/Labor / ?e O
OWNER'S NAME Last hJ^et/
First I A I
Owner's Address
Owners E-mail Address
q2 Ua��+n/DA� Ave
City 04 mo,- State I rr1
Zip I�6Zr Telephone
APPLICANT'S NAME Last I Fgrbt,
First I jh
Applicant's Address
Applicant's E-mail Address
q33 IUewW.0 St
viviCbro�t7i- 114 soI ctr. (a` -
city (&+4 Ill State I C
Zip 1 v 4 z-t Telephone qpg_ Lj tq_ 3133
vr..}First
ARCHITECT/DESIGNER'S NAME Last SAr�Q (,cs U�PII F Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F_
Zip Telephone[
ENGINEER'S NAME Last1 1�0lue5
First 06I''91 pS Lic. No. 6°�/�j3
Engineer's Address
Engineer's Er -..mail Address
5 Vio, Re(A-OAe,
City H�ofH AA`,���e,State I V�
Zip �Z,(tQ �j TelephoneFqII_Zt��- �IQC'
CONTRACTOR'S NAME/COMPANY11 4'.
,6r. Lic No. 1bZq�j-+ Class (3�6
/it
Contractor's Address �f Kt LI'fC S g I Ax_
Contractors E-mail Address
R5 °pPT
City State F--
Zip F Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. T4.523_ ODI$
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ?C1j o'L7 -OObV
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $