HomeMy WebLinkAboutXR2023-1077 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
[- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building [- Grading [—Drainage [- Elec r Mech [- Plum Cu Yd cutF— Cu Yd Fill F_
Project Address (Not mailing
address) r Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
Description of Work
Use WUConstType
�' �G
% �t7.i 1 ✓�LJi
r
i
# Stories #Units (if Res)
'U
_
Valua' nS ti�41Z.2o0
Materia aborTv�fv�Awryf'12,7p
New/AddSF� RemoJdel�SF� Garage/New/Add
OWNER'S NAME Last �'
First �t�
Owner's Address
Owner's E-mail Address
/i✓c�,
GK"-- b &� earl
City V4,i,Ib mom- /),�"
State 12A Zip 1j21i Telephone 5�" 7310 O 5�5G
APPLICANT'S NAME Last
5 First I G WW7P
Applicant's Address
Applicant's E-mail Address
City e�apAj?,4,77q-+r�/Y��—
State Zip G�Z/v75- Telephone3)pD�r�'(y
ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F Zip F_ Telephoned
ENGINEER'S NAME Last
First F_ Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
a4j:5 If,AUa_e*4:�T: Lic No. 796z�46 Class
Contractor's Address
Contractor' ress
Z 13 K .wa l!e r 1 G
City_
State A Zip �]4' Telephone Z
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $