HomeMy WebLinkAboutXR2023-0747 - Permit ApplicationPrint Form ` orii sheet for Combo Building & Solar Permit Application
r- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL I�
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Suite No
Description of Work
Use F7 Const Type
# Stories # Units (if Res)F7
New/Add SF Remodel SF- Garage/New/Add �—
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OWNER'S NAME Last Z
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Owners Address Owner's E-mail Address
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City t/r_n State C, _ Zip �a 2q Telephone 9 3 to —9 t(o S
APPLICANT'S NAME Last' 14a �e -z ,' First
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Applicant's Address r7 Applicant's E-mail Address
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City S; a NI{ $ State �—
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-- Zip a � -7 Telephone
ARCHITECT/DESIGNER'S NAME Last First �—
Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address
City State F— Zip F Telephone
ENGINEER'S NAME Last First 7 � Lic. NoT
Engineer's Address Engineer's E-mail Address
City State ZIP Telephone
CONTRACTOR'S NAME/COMPANY I CDC f-e M ( Lic No. to (22 0 Class
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Contractor's Address
Contractor's E-mail Address
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ZIP �— Telephone �� / E
City GS/q__n1*S� State CA ia62- P uG— Ei
SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
PERMIT NO. /SZfJZ 3-O�y7
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO \ Z_ _ PLAN CHECK FEES $