HomeMy WebLinkAboutXC2023-0246 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
F Comm] F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding
r Grading
r"Drainage r Elec r Mech F- Plum Cu Yd Cut 3
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Cu Yd Fill
Project Address (Not mailing address) F Flood (- Fire r Liq F- Landslide
FN/A Floor Suite Nc
12�10
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F_
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n of Work
New/AddSF3— Remodel SF Garage/New/Add3—
OWNER'S NAME Last
Owner's Address
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City ��C State r-til# —
APPLICANT'S NAME Last I Li /1 ar�S
Applicant's Address
1111,11 b V r
City C C Afock State I GA
AHCHITECT/DESIGNER'S NAME Last
Morns
Architect/Designer's Address
Z Cols
City 46100 I State �—
ENGINEER'S NAME Last
Engineer's Address
er
Use 3 Const Type 3
# Stories3 # Units (if Res)[_
Valuation $
F/6
Material/Labor
5 �/.I1Y'YNl
i4550C L
Owner's E-mail Address
ZIPI TelephorJGAQ�J, 7 J 7U
First
Applicant's E-mail Address
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Zip Z 21 Telephone • Z I yi
First Iri /1 INo. �—
Architect/Designer's E-mail Address
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ZIP Telephone
2•5v�,
First Lic. No.3--
Engineer's E-mail Address
City I State F— Zip r_ Telephone3--
CONTRACTOR'S NAME/COMPANY
Contractor's Address
--h� W. RYI- ST I b I
City I WS1Z1 ilvW67\
S'vX ASSOU6t}eS Lic No. t(j3gp21 Class�—
(J Contractor's E-mail Address
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State �.f Zip 012_(O2_1 Telephone C11�3 5-3-7c-)
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT I
PERMIT NO. X G zUz3 — oz`
PLAN CHECK NO. ?Cc�JZ?j — 16�