HomeMy WebLinkAboutXR2023-1206 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL .
Building F-Grading F—Drainage rElec rMech SZPlum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F— Flood r- Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
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Use � ConstType 1;'/7
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# Stories # Units (if Res)r
Valuation $
Material/Labor1;510c,
1—--
New/AddSF� CLj RemodelSF�— Garage/New/Add
OWNER'S NAME LastrAyli3O[2,First
e L.
Owneer''sj Address
Owner's E-mail Address
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City �;
State C� Zip '2 � Telephone w - ,2-521
APPLICANT'S NAME Last
1 Z� First j�,I tC
Applicant's Address
Applicant's E-mailillAAdddrresss
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City � � (7_
State LAZip � '�> ; � Telepho Z Gy 1 +f 7
ARCHITECT/DESIGNER'S NAME
Last First /
�ZlJ �/l,A � Lic. No. F—
Architect/Desi.[gne�r's Address
Architect/Designer's E-mail Address
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State— Zip ,!,'l, TelephoneLf7.�7
ENGINEER'S NAME Last
VIA- First I Lic No.F—
Engineers Address
Engineer's E-mail Address
City
State F_ Zip F— Telephonel—
CONTRACTOR'S NAME/COMPANY
NCM ",;II-v` c/A ^ ylA\ Lic No. —Class
Contraactors Address
Contractor's E-mail
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City
State Zip // U56 Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. M v6
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. I C24 ... �
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $