HomeMy WebLinkAboutXR2023-2463 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm] r Residential City of Newport Beach - Building Division
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Project Address (Not mailing address) F Flood r Fire r— Liq F Landslide �FV/A Floor Suite No
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Description of Work
Use ConstType
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# Stories #Units (if Res) t f 3
Valuation $
Material/Labor
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New/Add SF�— Remodel SF Garage/New/Add �—
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OWNER'S NAME Last � l' 1 � I �jr �
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Owner's Address �� f' �G
Owner's E-mail Address
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City I State f� _
Zip I �y(OGU Telep hone[�
APPLICANT'S NAME Last f
/ o.0 First
Applicant's Address Applicant's E-mail Address
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City L./��„_ v4, State— Zip '�uv� Teleph one .FWD
ARCHIJTE�CTT//D�E�SIIdNIER'S NAME Last t ; r"". ! : "' First - � G` Lic.
, No. s--
Architect/Designer's Address Architect/Designer's E-mail Address
City l.,- �._ >� 4.. _� State— Zip [ ? �`.. /'..� Telephone
ENGINEER'S NAME Last First F_ Lic. No. s—
Engineer's Address Engineer's E-mail Address
City State F— Zip — Telephones --
CONTRACTOR'S NAME/COMPANY I I 5 /I /�/ , mG Lic No. 4y9yJ" Class
/1 /C1�Yf/C!/,ontractor's
Contractor's Address
E-mail Address
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City �(State 5&y— Zip Telephone 7/ a
SETBACKS REAR SETBACKS FRONT PERMIT NO. /`�7�3 — ZL�63
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $