HomeMy WebLinkAboutPV2023-0380 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application SR
[- Comm'I P'lesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[- Building [- Grading [—Drainage [- Elec [- Mech
[- Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) [- Flood [- Fire r— Liq [- Landslide [-N/A Floor Suite No
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Description of Work
Use ConstType
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20 wt,`C!�
# Stories # Units (if Res)F—
E_>7yen�c�s S.00k� Jc.
Valuation
Material/Labor
New/Add SFF_ Remodel SFF— Garage/New/Add F—
OWNER'S NAME Last t v eki � R
First sr, y" l
Owner's Address
Owner's E-mail Address
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City Aj I,,, G2 f- /g,ear—tj State 1 " '
Zip GT 2,(D 2� Telephoned
APPLICANT'S NAME Last 1
First ��R.
r S
Applicant's Address
Applicant's E-mail Address
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City r/ewt} Xf- 4XALk StateFG_4
Zip [210(o Telephone Y4.3o24969
ARCHITECT/DESIGNER'S NAME Last N
First Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F_
Zip F— Telephoned
ENGINEER'S NAME Last—
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First R� Lic. No. ,G�F
Z U�
Engineer's Address
Engineers E-mail Address
II ^
to 7,S E, M
City C State C4
Zip Ct t� ( Telephoned
CONTRACTOR'S NAMElCOMPANY �/u�`pVEhttkf y sl$ f (2S Lic. No. �63 �qq 't Class _tp
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Contractor's Address
Contractors E-mail Address
n
bo I W • ?CA S�e- !/`''U
City i k State r �
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Zip �t��� �j. ,
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Telephone �; . 3� • 566
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. ?V1,0"— 0*
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $