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HomeMy WebLinkAboutXC2023-0322 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application F Comm'I F Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F- Building r" Grading rDrainage F Elec Project A� dd/ress (Not mailing addrress (, 2`> /�12542 L_JE$( of Work V VDE1\li -,�16ry F Mech F Plum Cu Yd Cut( Cu Yd Fill F Flood r Fire F Liq r Landslide F N/A Floor Ht44 ;'ir�o J06_ )IU LNSj IJ A1i _ New/Add SFF— Remodel SF�— Garage/New/Add �- OWNER'S NAME Last -QM? V12©{ k.A2 Tl GS First Owner's Address 2� I\eE___11 12 i C_t.111 11iL DQ.IV City e, ic FState APPLICANT'S NAME Last Applicant's Address 22'`jcl lL City l-5 �Fl�." �v State ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address Suite No Use F—ConstTypeF- # StoriesF_ # Units (if Res)F— S abor 6 t j o0o Owner's E-mail Address zip CI Telephone '1 q - 1 LC;_ First I ref Iz i Applicant's E-mail Address {{ .ii. y� I J � r�1s Ut tlGl''(Gii� Zip Gi Y7 Telephone (/c First Lic. No. F� Architect/Designer's E-mail Address City State [— ZiP F— TelephoneF� ENGINEER'S NAME Last First F� Lic. No.F_ Engineer's Address Engineer's E-mail Address City State [— ZiP r, TelephoneF� CONTRACTOR'S NAME/COMPANY i `(vryt Lic No. q.7�56S-,lass Contractor's Address tLv f { rt C� Con ractor's' EE mail Address City State— Z P CI I J Telephone %z�2 y_ �3 Y6 SETBACKS REAR SETBACKS FRONT �j PERMIT NO. i. SETBACKS LEFT SETBACKS RIGHT f WO USE ZONE PLAN CH X � DEVELOPMENT NO PLAN CHECK FEES $