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HomeMy WebLinkAboutXR2023-1149 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o m (- Comm'I Residential City of Newport Beach - Building Division o4 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL (-Building I- Grading r-Drainage I- Elec r Mech (- Plum Cu YdcutF Cu Yd Fill F Project Address (Not mailing address) r Flood r Fire r- Liq r Landslide rN/A Floor Suite No ,-* C/o Gsf C �— Description of Work Use F Const Type F VRwove G\ II I rR_ VIAC-c /p�SCa m�� �QQ IF Stories #Units (if Res) '' `! LCx6/ / New/Add SFF Remodel SF Garage/New/Add Valuation a U U p Material/Labor / OWNER'S NAME Last �CG First 2 h Vl Owner's Address Owner's E-mail Address ib 1?oc _e\ice City /`tI Cw�U✓`� C- 0.S-� State I cV-t• Zip q 5-7Telephone ?f </9 37 _V�JS_Gi APPLICANT'S NAME Last I v > O,/\ First i Applicant's Address Applicant's E-mail Address 0191 r-o)r-eso R�1s��b�',I � t City Cam C j�� � � � State F Zip I 9(),a�j �— Telephone 5-4�.Z--(off 9 - 9167 ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No. F Architect/Designer's Address ArchitecUDesigner's E-mail Address City I— State F_ Zip F_ Telephoned ENGINEER'S NAME Last � First F Lic. No.F— Engineer's Address Engineer's E-mail Address City State F— Zip F_ Telephoned 1 CONTRACTOR'S NAME/COMPANY �© Stan � 7 `lOVi, (3-" ,n Lic No. F3 pro SS3 ClassFF_ Contractor's Address Contractor's E-mail Address 661k f f I rogrc,�:.o City State- Zip I Job/ Telephone SC2 SETBACKS REAR SETBACKS FRONT PERMIT NO. X, E5 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ I