HomeMy WebLinkAboutPV2023-0310 - Permit Application194
Print Form_ j Worksheet for Combo Building & Solar Permit Application O2EWaoRm
r Comm'I r Residential City of Newport Beach - Building Division z
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U
r Building r Grading j—Drainage [ Elec F Mech j— Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) [ Flood r Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use F_ ConstType
IF Stories # Units (if Res)F—
Valuation
Material/Laa bor
New/Add SFF_ Remodel SF�
Garage/New/Add F_
OWNER'S NAME Last �[Q1`'
t� U
First
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Owner's Address
Owner's E-mail Address
, e oven
City State I l/A
v1 l ll/ Zip Fr I Telephone q g (`'b I
APPLICANT'S NAME Last ��
First
Applicant's Address
Applicant's E-mail Address
C `,
City 1 V ltr `\'e- State I v, l
ZipG Telephone 9T3g 0 99
ARCHITECT/DESIGNER'S NAME Last �— First �— Lic. No. F—
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City State F—
Zip I Telephone
ENGINEER'S NAME Last rTY ��
First ��A Lic. No G�lr �� g
J l
Engineer's Address
Engineer's E-mail Address
City State F—
Zip �— Telephone
CONTRACTOR'S NAME/COMPANY
Lic No. F_Class—
Contractor's Address
Contractors
actors E-mail Address
ckr, . c..r-
city �`u l State
Zip C� �'l� Telephone 5 1 7 .3 _ t! O g �1
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SETBACKS REAR SETBACKS FRONT
A
PERMIT NO.fVZ(J?vL 031 V
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. PG Z623 5
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $