HomeMy WebLinkAboutXR2023-2331 - Permit ApplicationPrint Form
- -_I Worksheet for Combo Building & Solar Permit Application
F omm'i F Residential City of Newport Beach - Building Division
NOTE- PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(—'Building r Grading F—Drainage F Elec
I— Mech
Project Address (Not mailing add
37(a Ubip, 5AI,A
Description of Work
SSA
I— Plum cuYdcut I
Flood F-" Fire F Li
q F Landslide
New/Add SFr------ Remodel SFr 5--
Garage/New/Add r---
OWNER'S NAME
Owner's Address
ale \)ocA.Q,4
Cityl NC-wpo,Lc j3Enc t+
APPLICANT'S NAME
Last) EScAta<
I Applicant's Address
I7.o Vl(lt jo, PL #loz
First ) BiwFMA V
Cu Yd Fill
F WA Floor Suite No
Use Const Type
# Storiesr l # Units (if Res)r—
Valuation $
Material/Labor F
1 Ot t
—�_ Owner's E-mail Address
Sbroh92 t?5 mtii I • ro M
State }
Zip 9Z6(nD Teleohnna 4n�11 �,:
First) WILSoN
Applicant's E-mail Address
City I COS h- )4CS State �— I WUsoNt? Wc2Lwnrc-oL.La,�
Zip 4f _,, I Telephone Z5-7-z y-60So
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address First
Lic. No. �—
Architect/Designer's E-mail Address
City I —�-- I
State F__ Zip F Telephone --
ENGINEER'S NAME
Last
Engineer's Address First ILic.jNoEngineer's E-mail Address
City
State �— Zip r---�---
Telephoner—CONTRACTOR'S NAME/COMPANY
D0y/t% f3utLDl.u/1, POIFn/ Lic. No. 10 Contractor's Address 4ti1o1
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Rkt,aA- PL t#!ot Contractor's E-mail Address
City
State CAr
I l� 15��,/ � I
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE
DEVELOPMENT NO
I lutLl
�olut'o Qwtg�,vE oC, tto.H
Zip ql 2tv27 Telephone
PERMIT NO.20�
PLAN CHECK NO. ' OZ
PLAN CHECK FEES u