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HomeMy WebLinkAboutXR2023-0812 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division Comm'1 (- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U j Building [Grading F-Drainage (-Elec rMech F-Plum Cu rd Cut Cu vd Fills v Project Address (Not mailing address) r- Flood [- Fire F- Liq r Landslide [N/A Floor Suite No Description of Work Use s Const Type # Stories # Units (if Res)s Valuation $ Material/Labor New/Add SFF Remodel SFF--:-- Garage/New/Add I OWNER'S NAME Last `A e,C �R. � - ------ First F Owner's Address Owner's E-mail Address 115 SHe�"� Fah L. City t J {' State F CA Zip `� 3 Telephone 9I APPLICANT'S NAME Last QY f ew First T VIIN Applicant's Address Applicant's E-mail Address ---7221__©ranS¢ i,sc�d Five- -- -jv3gf-r..e,r(�) '5_k girt SFvratr`cTn. City �jQlC�Zn- lamp-aVe State Cpk- - Zip _IZ$`"!'- Telephone -(-I►-i�)73-7--7a82, ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designees Address Architect/Designer's E-mail Address City State �— Zip Telephoned ENGINEER'S NAME Last First Lic. No.1— Engineer's Address Engineer's E-mail Address - city State �— Zip Telephonel— CONTRACTOR'S NAME/COMPANY _SLic No. Class ��naJ- ReSf�,rc.�ttmv. --3 Contractor's Address Contractor's E-mail Address 72_21Qran_ v warre,,. 1 victim rw+tav�, wad -�1 -� - `r -� s 5�°- city / State �'t j , 70*_ 2g�' - Zip � Telephone 3� 1 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. iw 2o2.2,_ 05 �( USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 7-1 r