HomeMy WebLinkAboutXR2023-1335 - Permit ApplicationSEW PoS,
Obi 6
Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB
MITTAL
uilding F_ Grading rDrainage r Elec r Mech (-- plum CuYdCut F_
7<6Cu Yd Fill
Project Address (Not mailinyg address) I— Flood r Fire j— Liq r Landslide rN/A Floor Suite No
0 Z-lp i' ` ��(v
F- r_
Description of Work
Use Const Type f
# Stories # Units (if Res)r
G
Valuation 5
Material/Cabo �S
New/Add SF Remodel SF
M %�
Garage/New/Add �/
OWNER'S NAME Last vp�
First
Owner's Address
Owner's E-mail Address
vDP ?
city�� State GW n�p/
Zip Ir � Telephone -7 4 l v /r:( �4P 3 0
APPLICANT'S NAME Last �Hf��j �(JI/t,4— First
Applicant's Address
Applicant's E-mail Address
City State �—
Zip Telephoned--
ARCHITECT/DESIGNER'S NAME Last �A�
�r S First ��� � — Lic. No.
Architect/Designer's Address /
l9 0 ��N P-P4/o
Arch itect/Designer's E-mail Address
��+o,��„ors
City �a�..0 f State
Zip Telephone % —7 5-73
ENGINEER'S NAME M/k Last
First F_ Lic. No.(--
Engineer's Address
Engineer's E-mail Address
City State �—
Zip F----- Telephone[ —
CONTRACTORS NAME/COMPANY
Lic No.77 7#cIass�
Contractor's Address
Contractor's E-mail Address
City �/ 'TJj'lJ�%} �i/"�� State
zip 7� Telephone ��'Z���9���
IF A
SETBACKS REAR SETBACKS FRONT
PERMIT
SETBACKS LEFT SETBACKS RIGHT
PLAN C
USE ZONE DEVELOPMENT NO
PLAN C ECK FE