HomeMy WebLinkAboutXR2023-0275 - Permit ApplicationPrint Form
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Project
Suite No
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OWNER'S NAME Last W; GOO �16� _
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Owner's Address -
Owner's E-mail Address
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APPLICANT'S NAME �/11GE�t
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Applicant's Address Applicant's E-mail Address
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Zip � _iZ Y_3Telephone 44-q - C-7 Z 1A so
J Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Address (Not mailing address) F Flood [_ Fire F_ Liq r Landslide f N/A Floor
escription of Work iut
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ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
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City I}60} u�_' State 614
First V10 Lic. No. FCT7qO
Architect/Designees E-mail Address
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Zip /GIOJ Telephone ! r% /-Y7.3-16J-O
ENGINEER'S NAME (���
Last t j (( JC' First F At - Lic. No. C �3 % S
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
Lic. No. F� Class
Contractor's Address
Contractor's E-mail Address
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State F Zip Telephoner®
SEAR SETBACKS FRONT Y Z�TL3 —
PERMITNO.
^T SETBACKS RIGHT
PLAN CHECK NO. QCZCZ�, � �•�<
DEVELOPMENT NO PLAN CHECK FEES $