HomeMy WebLinkAboutXR2023-1797 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application ��w°°Rm
F- Comm'I Residential City of Newport Beach -Building Division
V \ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G'
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Project Address (Not mailing address) r Flood r Fire r Liq f Land F_N/A Floor Suite No
Description of Work
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# Units if Res)I j
# StorieWb,
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New/Add SF Remodel SF � 0j b Garage/New/Add
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OWNER'S NAME Last First 9
Owners Address Owner's E-mail Address
70� l7p a L) P. (441
City �. {� State F . Zip 92bTelephone 917.71 99t'
APPLICANTS NAME Last WOyL First 2P,1.�J{_r
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Applicant's Address
Applicant's E-mail Address
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City nj , rJ - State I � ZipR TO 53Telephone ,)_; j.ZGr�,..� 0$y
ARCHITECT/DESIGNER'S NAME
Last First ��0_2y LiNo. L �! b 3-7
Architect/Designer's Address Architect/Designer's E-mail Address
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City (V' , _ State �( i Zip q p �� Telephone 9 ¢9• k 46 • ¢O e°5
ENGINEER'S NAME Last First �— Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State F_ Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY va* DG .J-/.� Lic. No. hoi,41 Class
tractor's Address % ` i Contractor's E-mail Address
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City �� State �
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SETBACKS REAR SETBACKS FRONT PERMIT NO. [�Q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $