HomeMy WebLinkAboutXR2023-1160 - Permit ApplicationPrint E2LT_j Worksheet for Combo Building & Solar Permit Application
FT�-comm,l �s i den ti a I City of Newport Beach - Building Division
I NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
P�611ding Grading r—Drainage f— Elec Mech F- plum Cu Yd Cut Cu Yd Fill
F
Project Address (Not Mailing address) F7 Flood F Fire F Liq F.- Landslide F_N/A Floor Suite No
�272 71,11, - —
fjssF7;7-
Description of Work ZWA_7_1P_^_ T)-n� ,A6f-
f, Use 7R/ Const Type •N�7
# StoriesF;E7 # Units (if Res)F/1?17
17e A
2_4.�F Garage/New/Add F Valuation $
New/Add SF[ ion
_E�Moi1 V_ - Material/Laborr/;-1/7-Z�0
OWNER'S NAME Last 11-7,4ir
First
Owner's Address Owner's E-mail-Address
--------------
City
State
------ zip Telephone
APPLICANT'S NAME Last 177 Z--4/,A Firs -J r L_)
Applicant's Address 41V Applicant'sE-mail Address
V/
City State Zip Tel - ephone
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City
Last First I jZ A^,/D/
Lic. No. 72 7Z7
Architect/Designer's E-mail Address
Stag
ENGINEER'S NAME Last First Llc.No.�-__
Engineer's Address Engineer's E-mail Address
"ty State zip Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. PT. 3-1.6 Class
Contractors Address Contractor's E-mail Address
City VA1q1VCr State Zip Telephone F77-?-.
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No e,?eV - 72�
USE ZONE nF%/P:l OPEAPNIT kin