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HomeMy WebLinkAboutXR2023-3090 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (- Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding j-Grading r-Drainage r-Elec rMech F__ CuYdFill[_ Plum CuvdCut Project Address (Not mailing address) I- Flood r- Fire j- Liq i- Landslide rN/A Floor Suite No q19 i3 s-d� Ai;r�- NYw lka�l (� 924 6eo � 3 Description of Work Use F—ConstType F- ' �G��J'�Glf.✓1 1 �tGav� # Stories1 # Units (if Res)l3 Valuation $ �A Material/Labor / New/Add SF 1„'LL Remodel SF Garage/New/Add h �- 44 OWNER'S NAME Last Ir9/7�frZ First n Owner's Address r � U C, Owner's E-mail Address City �t4� I State v Zip I4roo Telephone F-T APPLICANT'S NAME Last y First Applicant's Address Applicant's E-mail Address 1 s3010 k0fW&-,b1v4yob -til�-- j�/►�oss crv. City I jPq /.*_ 400 State Zip lyo 3 Telephone le . 970. ,1 f ? f ARCHITECT/DESIGNER'S NAME Last First Lic. No. F-- Architect/Designer's Address Architect/Designer's E-mail Address City I State F__ Zip I Telephone ENGINEER'S NAME Last �— First 7 Lic. No.F Engineer's Address Engineer's E-mail Address City State F_ Zip I-- Telephoned CONTRACTOR'S NAME/COMPANY G sht /_� cn I"1� I� � y Lic No. a �J[f r Class Address Contractor's Address Contractor's E-mailil Lf r? 4c4& x 1df /0 S 11AW-r �13r s ► Vw p.{•ar� a I o✓ City �, State I Zip 1 2t1 j Telephoned y- 10`f'd 3:47 SETBACKS REAR SETBACKS FRONT PERMIT NO. • SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. • USE ZONE DEVELOPMENT NO PLAN CHECK FEES $