HomeMy WebLinkAboutXR2023-1464 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application CNP
F_ Comm'I jkResidential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
'Building r Grading j--Drainage f Elec F_ Mech
F_ Plum CuvdCut cuYdFill F
Project Address (Not mailing address) F_ Flood
r Fire r Liq F_ Landslide [_N/A Floor Suite No
Description of Work
Use �- s ConstType
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c-,vhC>�A�z KI-CCW154
# Stories #Units (if Res)s
C'(1.1otnn [36rT1.1d�u�w�
New/Add SF� �� Remodel SF�2�� Garage/New/Add
Valuation$ Material/Labor G
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OWNER'S NAME Last ��.L
First wgl�l
Owner's Address
Owner's E-mail Address
606 f3c2� 03 1 /A
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City State
Zip Telephone Pik (;r,0 0,5--7
APPLICANT'S NAME Last
First E3C>15
Applicant's Address
Applicant's E-mail Address
P b• f�}� I SI 2
V,TA I r1 e_-7 C
City V �d�� (�.} State Gja
Zip—/(iCpS l Telephone (�G0/ 6SO
ARCHITECT/DESIGNER'S NAME Last �Firstl\p13 Lic. No. �16
Architect/Designer's Address
Architect/Designer's E-mail Address
-Po,
City I State F_
Zip F_ Telephoned
ENGINEER'S NAME Last
First I Aa 4 Lic. No. , 5rj
Engineer's Address
Engineer's E-mail Address
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Ip,-t 4= �-- -C�
City VILIJ V'(1/� State �
Zip 6 G Telephone -1I4 5-J4 �12S
CONTRACTOR'S NAME/COMPANY ,tU 3 , Eder 5 c \ f>c S. 5 Lic No. F1, pat 3<12 Class
Contractor's Address 2z6 D S L j n \gE¢, 51_
Contractor's E-mail Address (_�5\-6„M i3-; I • S� Si3C (;lo
City AState C_p
ZiP DTI?-__g Telephone '7/cl wt2_��hij
3001 7
SETBACKS REAR SETBACKS FRONT
PERMIT NO. XRzo?.3. 146�pN�j
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. p( OZ3 J G
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $