HomeMy WebLinkAboutPV2023-0461 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I )Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F-Drainage rElec rMech FPlum Cu vd Cut7— Cu yd Fill[_
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use J l 2 ConstT e
yp U6
# Stories[— # Units (if Res)F-
1
1�mW5 jwell* (9 2.
Sgok
New/Add SF ��— Remodel SF
Garage/New/Add
Valuation $
Material/Labor F�/
OWNER'S NAME Last 607,24%
First I IffAtk
Owner's Address
Owner's E-mail Address
W Afer1 05a br
z �, lP, . cop"
City l State � Zip 1i% Telephone
APPLICANT'S NAME Last F .5
' /
First aJCa�
Applicant's Address
Applicant's E-mail Address
y 5FGg Paws Arc
w, 5u�, 5uw�la�ac.rovU
City phi M�� State �q
Zip Z!�'1 Telephone
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zip F Telephoned
ENGINEER'S NAME Last
First F Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City State F—
Zip F_ Telephone[
CONTRACTOR'S NAME/COMPANY 4 /, � _ _
L li\//I/]iJ
8a/� et6 Lic. No. 103 346 Class 6 ib
Contractor's Address
Contractor's E-mail Address
Ga P,91 ka 13
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Z�c®�',(/ir�' In U�OG.LoIM
r!I
City State �G�
Zip 4Y� Telephone q(�/A_ 7 .(�/GG
v ItOZJ (�'
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. PCZ023' ZOS6
USE ZONE DEVELOPMENT NO l 11W�� OI6� PLAN CHECK FEES $