HomeMy WebLinkAboutXC2023-0177 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I F Residential City of Newport Beach - Build'
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visionng
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I- Grading I -Drainage F Elec
Address
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uescription of Work
Inc
New/Add SFF —
OWNER'S NAME
Owner's Address
city (`r�—
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Cu Yd Fill
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Suite No
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Remodel SFF — Garage/New/Add �!
Last I Z2Lk A,,rz � LLB First
NA_ N 4
41 A.II&Z
State CA
APPLICANT'S NAME L w —
Use ConstType�
# Storiesr— # Units (if Res)F-
Valuation
Material/Labor
Owner's E-mail Address
Zip Telephone` - Gq"A -$IQ
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CS h✓+i First
Applicant s Address `'ij^-C_
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Applicant's E-mail Address
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City�
State G}i
Zip
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9Zit42 Telephone
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ARCHITECT/DESIGNER'S NAME
Last lac 4ic Loc,p�,(t;ir t�
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Architect/Designer's Address
c
S Lic. No.
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Architect/Designer's E-mail Address
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City '"itEnfl'tIg"I ,2CCti State C2
Zip
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Oj 6, �' Telephone i5
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ENGINEER'S NAME Last
Engineer's
Address
F
2 1-7z Ida
Engineer's E-mail Address
City
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State F7 Zip F92
) Telephone
CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
; 40
City 1 j ?� State F� _
Zip g2GL2 Telephone qK9- (AL(-(_ biro
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $