HomeMy WebLinkAboutXC2023-0093 - Permit ApplicationPrint Form
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Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F7*&ading F-Drainage [Elec F-Mech F-Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood (— Fire F_ Liq r Landslide [N/A Floor Suite No
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Description of Work
Use ConstType
# Stories #Units (if Res)
G 517/a�C 16CaLT/Gn G lJY6/�o�ti°
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New/Add SF Remodel SF Garage/New/Add
Valuation ��/
Material/ abor
OWNER'SNAME Last �j/�Ga�n[ <t First
Owner's Address �Oeer's E-mail Address
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City �I'f�IYIC� State GA- Zip 2 6 % Telephone y?
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APPLICANT'S NAME LastQS7_¢n7�Z. _' First �raulc�rn
Applicant's Address Applicant's E-mail Address
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City / ✓/A L State L'� f4 Zip / 26�e _ Telephone g /' / • / 2 3 b'/lyV
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No.
ArchitectlDesigner's Address Architect/Designer's E-mail Address
City State 7— Zip F— Telephoned
ENGINEER'S NAME Last 544 7 � _ First orm �% Lic. No. 6�S£', Z
Engineers Address Engineer's E-mail Address
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City Y_[n, State C� Zip / Gv�B- Telephone[I yg, gZs. 000
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractors E-mail Address
City State �— Zip � Telephoned®
SETBACKS REAR SETBACKS FRONT PERMIT NO. C%�j
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. G2023 -�o
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $