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HomeMy WebLinkAboutXR2023-0053 - Permit Applicationl Print Form Worksheet for Combo Building & Solar Permit Application Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F-Building rGrading rDrainage [Elec rMech rPlum Cu YdcutF Cu Yd Fill Project Address (Not mailing address) F Flood r Fire r Liq r Landslide CN/A Floor Suite No � 2 -31 Ntvtpo27 Fjrzkk CA, 9?-6&51-- F— Description of Work `b, eoyw(,( Use I— Const Type rJ�--w 60' o" ?-sDwooz PzoP�,y Lt�,ji_ h;_0,Jcf- # Stories #Units (if Res)F Z �iLHS'f� A-t F�S�orl-c of= PTzo'P��-�� __ Valuation New/Add SF � Remodel SF � Garage/New/Add MateriaULabor OWNER'S NAME Lastl First[ JoHtj Owner's Address Owner's E-mail Address n City State Zip `IZ,6Z5 Telephone (310� APPLICANT'S NAME Last Mtw7n rs' Applicant's Address �.�� NEvaPor�-� Cyr•+-r� � i�a... s'r� City I 0E_v"Pm--t State t✓1� Firstl Applicant's E-mail Address 6F ttL_-loL,6v_.C_o,-, Zip Ig2(p lv O Telephonel C2o2;� ARCHITECT/DESIGNER'S NAME Last -- pJ MAD First C��I G� Lic No. l— Architect/Designer's Address Architect/Designees E-mail Address Q0P1tzz1P1VLbhV'�t4 5 ,�.c,�jrA City B015f_ State D Zip ��j})(p Telephone (I�j Zf(-IbbQ)3 ENGINEER'S NAME Last ip:o1-7-- First To N t - Lic. No, 47-ro z-,: - Engineer's Address Engineer's E-mail Address PjR-O- Ht1R-S"[ �---• CJ (�. ZOD City ��f3Tlti{C11OAF VfLFtC}1 State Zip 1Z,(p4(Q- Telephone CONTRACTOR'S NAME/COMPANY Lic. No. I00_ -353j ClassF JRu.,No�s� �or�n(zS r�c� I Contractor's Address l7c� f�rv�Pa�T CT�tz City ►�r__WvolT ��RL}�1 State GA SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's E-mail Address c�t�5 i In1@ SfHL-NoLlw— . C0&A, Zip �Zip(P � Telephone CW q j"7Z?jl - v)+ PERMIT NO. W­1�3 - ooS3 PLAN CHECK NO. 10 ! l USE ZONE DEVELOPMENT NO PLAN CHECK FEES $