HomeMy WebLinkAboutXC2023-0054 - Permit ApplicationPrint Form WorkSheet for Combo Building & Solar Permit Application O
j Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
['Building [Grading [Drainage rElec rMech [Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
11ol _A�la�� I& - i kjPWEa_O W7_06_ 1_7 c7!9
Description of Work Q WV— 6-Al2G_
Use FF_ ConstType 1 1 A
T�6 l
#Stories #Units (if Res)
�nlG Lvg�_1�C �'?irZ�l_-95-
Valuation 17T�r/
Material/Labor
bor
L d �
New/Add SF � Remodel SF l�G�� Garage/New/Add �—
— � —
OWNER'S NAME Last � b�l `� First
Owner's Address Owner's E-mail Address
I1(6C�tGAv/ qf�_ FrYave� �Y� ��c6�Y.�
City� /I 13r State Zip Telephone —2""t� —
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
2G j6 l �s> Ili �1 IZ �L� 2 a r <� ✓-�r�Gli fE'6l& , c-a ri;i
City L;TPSf/Z/A�\(c) State F7A Zip q - Telephoned
ARCHITECT/DESIGNER'S NAME Last r/Firs Lic No.
v� 7�
1 —
Architect/Designer's Address Architect/Designer's E-mail Address
:17(
-
City��71`2/�j" Ot�l-Y/ State Zip ��%�. Telephone_9
/
ENGINEER'S NAME Last �r First _ Lic. No.1—
Engineer's Address Engineer's E-mail Address
City �— - State F_ Zip Telephoner
CONTRACTOR'S NAME/COMPANY @S J Lic. No. �— Class
COW%f12 �u..�f�.-C ✓L -
Contractor's Address Contractor's E-mail Address
City /j) � � - � �I,� State Zip (',( a� � � Telephone 9u� / /� e 1 _O (0 U 3
y` ! cSC/
SETBACKS REARSETBACKS FRONT PERMIT NO. X a Dk 3 — O US t'1,
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Ou 0D
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $